Health economist Professor Alan Maynard looks at NHS reform plans from 1974, and finds that all too little has changed.
An appraisal of the history of NHS reform since 1974 shows a naïve belief that altering organisational structures will improve the processes of healthcare and benefit patients in terms of their outcomes: i.e. improve their length and quality of life.
The links between structure, process and outcome are assumed, with reformers asserting unevaluated and un-evidenced conclusions from their repetitive and learning-light organisational reforms.