Intended for healthcare professionals

Rapid response to:

Editorials

Reorganisation of the NHS in England

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c3843 (Published 16 July 2010) Cite this as: BMJ 2010;341:c3843

Rapid Response:

It beats me how they can keep going

It must be very dispiriting being an academic whose expertise is the
organisation
of health services. People like Keiran Walshe, Chris Ham and others, seem
every
couple of years to have to repeat what they have already written (1), to
politicians
who took no notice last time and will take no notice this time. I have
lost count
of the number of times I have read, from Walshe, Ham and others, that
structural
reorganisations don’t work, that the transitional costs of large scale NHS

reorganisations are huge and the projected savings rarely realised, and
that
reorganisation adversely affects service performance. Politicians seem
incapable
of realising that "There is no perfect structure. ...[They should make]
existing
arrangements work. An important starting point is to learn to leave things
alone."
(2)

1. Smith J, Walshe K, Hunter DJ. The "redisorganisation" of the NHS.
BMJ
2001;323:1262-1263.

2. Normand C. Radical changes can be made only if the basic
environment is
stable. BMJ 2002;324:672.

Competing interests:
None declared

Competing interests: No competing interests

12 August 2010
Neville W Goodman
Retired Consultant Anaesthetist
BS9 3LW, UK