Intended for healthcare professionals


A letter to the next secretary of state for health

BMJ 2015; 350 doi: (Published 29 April 2015) Cite this as: BMJ 2015;350:h2296
  1. Gareth Iacobucci, news reporter,
  2. Rebecca Coombes, head of features and investigations,
  3. Fiona Godlee, editor in chief
  1. 1The BMJ, London, UK
  1. Correspondence to: G Iacobucci giacobucci{at}

The BMJ provides a checklist for a healthy NHS

Dear Secretary of State,

At the time of writing we don’t know who this letter is addressed to or what coalition or partnership deals will be needed to form a government. What we do know is that the next five years are likely to be the most challenging and decisive that the NHS in England has ever faced. Our intention in writing this letter is to set down in a non-party political way what we believe is needed to heal the NHS.

Let us start with the current situation as we see it. Still reeling from the costly and distracting Lansley reorganisation, with virtually flatline funding in real terms since 2010,1 and the growing demands of an ageing population with increasingly complex needs, England’s NHS is stretched close to breaking point. Extreme cuts to social care have exacerbated the pressures, causing knock-on effects across the service.2 Waiting times for treatment are the longest for many years.3 Staff morale in many parts of the service is at rock bottom because of real terms pay cuts and the relentless workload. Many GPs are retiring early, and new recruits are thin on the ground.4 Patient safety is now at risk, with …

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