Conclusion

The care system in the United Kingdom has become seriously misaligned with the needs of the population in the 21st century. The NHS was a stunningly bold and appropriate system in 1948. Despite the skill and dedication of UK clinicians and carers, and despite the UK’s leadership in biomedical science, the structures of the NHS have barely evolved since they were formed in 1948. This cussed rigidity would be a major disappointment to the service’s major architect:

“We shall of course find from time to time that alterations and adjustments have to be made. We are not ridden by doctrine; we are a nation very largely of visionary empiricists, able to adjust things where necessary, and between us we shall have a standard of health service that will be the envy and admiration of the world.”⁴⁴

It is time that all of us mobilised to deliver, finally, on Nye Bevan’s optimism and sense of duty.