Mention the name Alistair Cooke, and his legendary Letter from America immediately springs to mind.1 For 58 years his weekly commentaries on happenings in the United States were beamed by the BBC to many countries around the world, including Australia.

Indeed, Cooke’s Letter from America was the catalyst for commissioning a regular short piece on the “goings-on” in health care, the medical profession and academia in the United Kingdom.

The opportunity to view these through antipodean eyes was entirely fortuitous. Three prominent Australian academics left our shores some 3 years ago to take up prestigious positions in the “old country”: David Weller moved from Flinders University to Edinburgh, Konrad Jamrozik from the University of Western Australia to London, and Richard Heller from Newcastle University to Manchester.

With little ado, our expatriate trio agreed to provide regular comments on medicine in the UK. The commentaries were to be journalistic rather than academic, with a humorous or quirky edge, but were also to reflect the profession’s sensitivities and conservatism. And so the Postcard from the UK was born.

But now, almost 2 years on, the Postcard will cease to be delivered, and this issue carries the last one. This unfortunate turn of events is due to the break-up of the Postcard’s triumvirate, with the return of one of its members to Australia. Thus, all parties concerned agreed to “pull the plug” on the Postcards.

Since December 2003, various Postcards have amused, amazed and even affronted some of our readers, both in Australia and in the UK. The more memorable Postcards have covered such issues as: UK health inequalities, which still reflect the British class divide;2 the political crusades imploding the National Health Service;3 the dependence of the NHS on “the energy of slaves” — through recruitment of doctors and other health professionals from the former British Empire’s colonies;4 and the Sir Humphrey Appleby approach to the bureaucratic Research Assessment Exercise, which gives the lie to the commitment of UK universities “to profess”.5,6 The final Postcard in this issue of the Journal (page 556) explores the difficulties confronting the NHS in bringing IT systems on stream.7

What, then, is the lasting message of the postcards?

The issues involving the UK health system, its medical profession and academia are mirrored in our system, and the solutions seem to come from the same cookbook. Both countries’ bureaucracies are incredibly insular and spawn ill-conceived ideas, reflecting their isolation. But, overall, we are left with an impression of the political impotence of the UK medical profession and its institutions compared with those in Australia, a situation to be expected if most doctors are, in reality, public servants.

In the meantime, sincere thanks to the Postcard’s trio and vale to our Postcard from the UK.