Project Management

Health O0n The Edge - The Future Of The NHS In England

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Executive Summary

Back in 1997 - just before the general election that swept Labour to power - The author remembers writing in the journal Public Management about the need for strong political leadership to prevent the NHS descending into chaos. My argument was that the combination of increasing pressure on public expenditure, increasing health needs caused by demographic change, advances in medical technology and rising public expectations would require fundamental change. A system dominated by 'temples to 1960's medical technology' (as the author called large acute hospitals), with a weak system of GP-led demand management and with few incentives for providers of services to improve productivity and raise quality, simply could and would not survive - no matter what Governments thought or did.

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