The British National Health Service 1948-1978: should we start again?

The author concludes that since the British National Health Service is the product of a complex history, it is impossible th start again: however, the removal of three factors and the development of one would greatly improve it. The factors to be removed are: (i) the witch hunt against management, which has become the scapegoat for other ills; (ii) the medical model of health care, which is no longer relevant or practical; (iii) the industrial model, which has forced the NHS into an inappropriate style of management, trade unionism and employment patterns. The factor to be developed is the clinical skill of the nurse; such development requires improved educational opportunities and a clinical career structure.