Abstract
By the time you read this, an unlikely alliance of assorted royal medical colleges, medical trade unions, and management organisations might have laid siege to Richmond House, citadel of the Department of Health, demanding Andrew Lansley's head is ripped from his body and skewered atop the gates that guard the Houses of Parliament. Alternatively, rebels and evil empire might be sharing a gin and tonic to discuss a few thousand further amendments to Lansley's health bill.
Readers might not welcome my efforts to downplay the seriousness of the moment. The NHS is in danger and must be saved, say the anti-reformists. The NHS is on its deathbed and must be saved, say the reformers. The reality is nothing of the sort, of course. The NHS is like a juggernaut on a highway, ever moving and barely deviating. The highway might have many lanes created by different legislation but the direction of travel alters little.
You might consider this empty rhetoric or you might take Rudolf Klein's views into consideration [p 48]. “There is only one reasonably confident conclusion that can be drawn from the history of successive reforms,” explains Klein. “Neither Lansley's vision of transformed NHS, nor his critic's nightmare of a service stumbling towards collapse is likely to materialize.” Klein bases his argument on years of evidence-based observation of the NHS and the papers published in a supplement to the current issue of Journal of Health Services Research and Policy, a health policy journal published by Royal Society of Medicine Press.
Klein's editorial doesn't simply provide clarity in an NHS fog of confusion. It also signals a new initiative by JRSM to highlight the best of what's published in RSM Press' portfolio of twenty-six journals, both by way of editorials like Klein's and a new RSM Press Round Up page [p 90]. We believe the whole is greater than the sum of its parts; a thought that our NHS protagonists might want to consider as they lay waste to each other. For if you were to be persuaded by Klein's verdict on the inconsequential effects of NHS reform—and I am—you might conclude that the current war minus the shooting is really politics by any other name, except that the 2012 vintage is a particularly toxic and vindictive grape.
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