Intended for healthcare professionals

Rapid response to:

Analysis And Comment

Democratic control is essential

BMJ 2006; 333 doi: (Published 27 July 2006) Cite this as: BMJ 2006;333:251

Rapid Response:

NHS as a Political Football

Health is too important to leave solely in the hands of the
politicians. Communities such as the USA with a laissez-faire attitude
towards government control of health have poor overall health statistics.
However compared to health statistics in other first world countries, the
UK is no better than mediocre. The USA also contains some examples of
excellent comprehensive health care in the shape of HMOs such as Kaiser
Permenante and the like.

It is impossible to have a health care system which is simultaneously
of high quality, fully comprehensive in scope and free at the point of
consumption. As politicians will never explicitly deny any form of care, a
politically driven health care system such as the NHS is committed to
comprehensive care without cost at the point of consumption as its major
priorities. No surprise then that some NHS care is of questionable

Politicians can and should set aims and objectives for the NHS and
leave the development and implimentation of these to an independant
administrative body. Remember how well the Bank of England has managed the
economy since being set free of the Treasury. Just think what our TV would
be like if an elected politician ran the BBC?

Competing interests:
Currently involved in developing improved access to elective secondary care in N Ireland

Competing interests: No competing interests

04 August 2006
Robert Lewis Miller
222 Woodstock Road. Belfast BT6 9DL