Intended for healthcare professionals

Rapid response to:

Analysis And Comment

Steadying the NHS

BMJ 2006; 333 doi: (Published 27 July 2006) Cite this as: BMJ 2006;333:254

Rapid Response:

There is no "UK health service".

One warms to Donald Berwick's steadfast support for the NHS,
eloquently expressed again now. We forgive him for his error and that of
the other authors in this series of articles in writing about the NHS as a
UK model when commenting only on the NHS in England as directed from
Westminster. The NHS in Scotland, in particular, is different in many

There is of course a need to survey and audit the differences with
the other home nations and I communicated that suggestion to the authors
of a paper last year (Richard G A Feachem and Neelam K Sekhri Moving
towards true integration BMJ, Apr 2005; 330: 787 - 788) about the NHS in
England. They too seemed unaware from a distance that England is not the

In Scotland, I was glad that two reforms ago when we got Local Health
Care Cooperatives, they had no commissioning responsibility. There was
enough to do without that. Just when LHCCs had matured and might have
taken on that challenge, reform has produced Community Health Partnerships
which in my area have yet to have a whimper of a profile some 18 months
after their birth.

Competing interests:
None declared

Competing interests: No competing interests

30 July 2006
Philip A Gaskell
Allan Park Medical Practice 19 Allan Park Stirling FK8 2QD