Intended for healthcare professionals


The NHS through American eyes

BMJ 2000; 321 doi: (Published 23 December 2000) Cite this as: BMJ 2000;321:1545

Comments on historical context.

This article presents the NHS as if in a crisis for which an
appropriate remedy will produce recovery. The status quo for healthcare in
Britain may infact be a crisis such as currently exists. 100 years age The
Times produced an article on the severe problems in delivering healthcare
affecting both the charitable and non-charitable hospitals in London(1)and
continuing concerns led to the establishment of the NHS in 1948.

The breadth of material covered in this article when condensed for
publication lends itself to a polemical style which Berwick and Leatherman
may not have intended. In contrast Berwick and Smith eloquently stated the
case for improving the NHS in 1995through the creation of learning
organisations based on collective knowledge(2).

We may have the usual crisis in health care but we also have a means
to address it.

(1) 100 years ago. The finances of the London Hopsitals. BMJ

(2) Cooperating, not competing, to improve health care. Berwick D &
Smith R, BMJ;310:1349-1350.

Competing interests: No competing interests

03 January 2001
Martin Moran
Family Practitioner
Maine Medical Center. Portland, Maine, USA