If births can be difficult, so can rebirths. The creation ofBritain's National Health Service (NHS) in 1948 provoked politicalfriction and medical opposition. Its current transformationis also proving contentious. In the first few months of 2006,the word "crisis" and the NHS were reunited in newspaper headlines— a coupling familiar throughout the history of the service.NHS trade unions staged protests as staff were laid off; patientsworried as media stories about hospitals delaying treatmentor economizing on drugs multiplied; the chief executive of theNHS took early retirement; and the prime minister rushed tothe defense . . . [Full Text of this Article]
The Emergent Model
Increasing Capacity
Power to the Periphery
Hands-Off Control
Patients' Choice
Payment by Results
Crisis or Blip?
Policy Tensions and Strains
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From Bath University, Bath, the London School of Economics and the London School of Hygiene, London — all in the United Kingdom. An interview with Professor Klein can be heard at www.nejm.org.
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