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A statute of liberty
  1. Geoff Hughes
  1. Correspondence to Professor Geoff Hughes, The Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide 5000, Australia; cchdhb{at}yahoo.com

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A statute of liberty?

Equity and excellence: Liberating the NHS,1 the white paper published by the Department of Health in June has now been followed up with a letter from Sir David Nicholson, the English NHS' chief executive 2 that outlines transition arrangements to the new health and social care system proposed in Equity and Excellence.

The white paper (61 pages long) heralds yet another reform of the NHS, arguably the 16th major one in the last 30 years. Described as challenging and far-reaching reforms that will drive NHS cultural changes, some key points include:

  • Patients will be at the heart of the NHS; shared decision-making will become the norm (no decision about me without me—their italics) and they will have increased control over their own records as well as choice of any provider, choice of consultant-led team, choice of GP practice and choice of treatment.

  • Patients can rate hospitals and clinical departments according to the …

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