What drives the NHS?

Konrad Jamrozik, Richard F Heller and David P Weller
Med J Aust 2003; 179 (11): . || doi: 10.5694/j.1326-5377.2003.tb05702.x
Published online: 1 December 2003

The UK’s National Health Service (“the NHS”), with 1.3 million employees, has now become the world’s second largest employer after the army of the People’s Republic of China. How can anyone drive anything that large? The former UK Secretary of State for Health, Alan Milburn, tried doing it for 6 years and, within days of his resignation, was instead defending tobacco industry jobs in his own constituency. At least he wasn’t driven to drink; to us, as newcomers to the United Kingdom trying to make sense of this unwieldy bureaucracy while surviving the deep midwinter, a drink looks pretty good.

  • 1 Department of Primary Health Care and General Practice, Imperial College of Charing Cross, London, UK.
  • 2 Evidence for Population Health Unit, School of Epidemiology and Health Sciences, School of Medicine, University of Manchester, Manchester, UK.
  • 3 Division of Community Health Sciences, University of Edinburgh, Edinburgh, UK.


  • 1. Davies HTO, Harrison S. Trends in doctor-manager relationships. BMJ 2003; 326: 646-649.


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