Views & Reviews Review

Our weird relationship with the NHS

BMJ 2013; 346 doi: (Published 26 March 2013) Cite this as: BMJ 2013;346:f1938
  1. Nick Seddon, deputy director, Reform
  1. nick.seddon{at}

Is the only way to fix the NHS to change the British people’s relationship with it?

When Robert Francis QC gave his verdict on Mid Staffordshire, he chose not to scapegoat individuals, because the “culture of the NHS” had committed the crime. Many were not happy about this, but, says Roger Taylor, he was right. “The challenge is changing it.”

For more than three decades politicians, professional associations, patients’ groups, and commentators have called for changes in the culture of the health and social care system. Governments have produced veritable libraries of policies and proposals, but the ensuing hyperactivity has not brought enough progress.

Roger Taylor is cofounder of and director of research at Dr Foster—“best known,” the book’s press release tells us, “for publishing the guides to HNS [sic] care such as the Good Hospital Guide.” If there is a central question, it is this: how do we allow appalling standards of care to persist? In 2001 Dr Foster exposed the “big lie” that the NHS provided a uniform service across the country. The new big lie is that we have …

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