Despite fiscal stress, public confidence in the National Health Service (NHS) remains strong; privatisation has not hollowed out the service. But if long term challenges are to be overcome, pragmatism not rhetoric should be the guide.

Martin Powell makes the point that the death of the National Health Service (NHS) is constantly asserted without criteria. This article suggests that the NHS is many things, which makes criteria unstable. The alignment of interests in the structure of the NHS enables both overheated rhetoric and political strength, and that pluralization of provision might actually undermine that alignment over...

the article by brenna and spandonaro on interregional mobility for acute hospital care in italy raises important issues concerning social and territorial equity in a healthcare system. based on regions and private providers’ strategic behavior, the hypothesis adopted to explain patient cross-border mobility (cbm), demonstrated by statistical analysis, may be further explored using qualitative m...

the paper by gilbert et al. should be on the table of every politician and national health service (nhs) manager in the run up to the general election, when the nhs is at the hustings. they have raised profound moral dilemmas of the internal and external market in their present form, such as the practicalities of distributive justice and the enhancement of autonomy – to which are added the pres...

BACKGROUND Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), in its most severe clinical presentation, can result in patients becoming housebound and bedbound so unable to access most available specialist services. This presents particular clinical risks and treatment needs for which the National Institute for Health and Care Excellence (NICE) advises specialist medical care and moni...

This is a commentary on Gilbert and colleagues' (1) paper on morality and markets in the National Health Service (NHS). Morality and values are not ephemeral qualities and universal healthcare is not simply an aspiration; it has to be enshrined in law. The creation of the UK NHS in 1948 was underpinned by core legal duties which required a system of public funding and delivery to follow. The mo...

I am very proud of living in the UK where there is a National Health Service (NHS) that is (more or less) free at the point of delivery. However, it is becoming widely acknowledged that the health service in England needs to change significantly if it is going to survive the next decade and beyond. The new chief executive of NHS England (Simon Stevens) has tried to tackle this head on and laid ...

Martin Powell suggests that the death of the English National Health Service (NHS) has been announced so many times we are at risk of not noticing should it actually happen. He is right. If we ‘cry wolf’ too many times, we risk losing sight of what is important about the NHS and why.

BACKGROUND no research has investigated how older people's use of NHS Direct, the 24-h telephone health advice and information service in England and Wales, varies according to geographical location and deprivation. OBJECTIVES to describe the geographic pattern of older people's use of NHS Direct and examine the relationship between service use and deprivation. DESIGN descriptive, explorato...

OBJECTIVES Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on p...