Developing the Health Service: Chaos or Cohesion?

This Case Study outlines some aspects of how healthcare may be developed in a manner that embraces improved sensitivity to the needs of individuals and local communities; improved efficiency, quality and effectiveness of services; improved equity that strives for the fair dispersal of limited resources according to need and improved cohesion between different health and social services. It encompasses models of commissioning at district, locality and practice levels, and challenges several assertions made by politicians from both the Conservative and Labour parties. It offers a logical means of developing a primary care‐led NHS that is consistent with a quest for equity, and that truly supports the separation of purchasing from commissioning.