The key problem the NHS has is years of under investment in staff, particularly doctors, nurses and other health professionals, along with buildings, equipment and new treatment technologies. Recent comparisons with the Kaiser system in California suggest that it is also under-managed and has inadequate information systems. The NHS is rightly accused of not being sufficiently focused on the patient. A change towards more competition, patient choice and building patient feedback in would help to deal with this but what is often forgotten is that all of these require increases in capacity.
Nigel Edwards is also Visiting Professor London School of Hygiene & Tropical Medicine
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