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Wednesday 26th October 2016

Can the NHS be saved?

30th April 2010

Writing for The Times Online, consultant oncologist Professor Jonathan Waxman suggests the internal market has been a costly disaster for the NHS.


Each political party is claiming only their party will save the NHS.

Amid praising nurses and lauding doctors, pledges are being made not to cut frontline services despite the need for austerity.

In the past, a hospital was run by about three people with medical staff treating patients without guidelines, targets or form filling and without the internal market which has wreaked havoc since it was introduced by Margaret Thatcher.

The billing system is costly, bureaucratic and problematic.

Meanwhile, the number of administrators in the NHS, said to be 75,000 but possibly as high as 250,000, continues to increase.

This has led to a general feeling in the NHS of disempowerment of the professionals.

While the principle of care for all from cradle to grave is worthy, current reality is a “cradle rocked by accountants”.

Politicians have made changes to the NHS but in recent years, these have caused to fragmentation and not led to cost saving.

The internal market has failed because it does not consider the health of the nation as a whole, merely the finances of a single hospital department, a local hospital or GP practice.

The answer is to go back to the old discipline of the NHS, let the doctors and nurses manage medicine, “shove the internal market in the bin and screw down the lid.”

This election should see the internal market ditched and politicians helping the NHS do what it does best - treat patients without the “crucifying expense and ridiculous parody” of competition.


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