Last week the health secretary Patricia Hewitt pledged to continue with plans to introduce competition into primary care. In place of the single NHS, Britain now has an increasingly decentralised health system, a proliferating network of service providers and independent treatment centres, and hospitals built and financed by private money. Companies have already been drafted in to run surgical clinics; some diagnostic services are now private; and new out-of-hours primary-care services are on their way. The intention behind these reforms is not necessarily bad but the Government's latest proposals are untested and, therefore, irresponsible and potentially dangerous, states the editorial.

The Lancet comments: "Patricia Hewitt's error, repeated over and over again by her predecessors in all governments, is to change the system based on ideology rather than evidence. No drug would be licensed without good data about its safety and efficacy. Yet Britain's health system is freely turned upside down without any reference to evidence or any plans to study the controlled effects of these reforms. This kind of haphazard policy-making risks the welfare of patients and the commitment of health workers. The Government's latest proposals are untested and, therefore, irresponsible and potentially dangerous. Patricia Hewitt is playing fast and loose with the public's trust. Until there is independent evidence of the effects of her policies, her programme of wide-ranging privatisation must be stopped."

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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
6-Oct-2005