ABSTRACT

The growth of the National Health Service (NHS) over the first 50 years of its life has resulted in it becoming a victim of its own success. During the 1990s there was an accelerating rate of change as Governments and society began to recognise the financial and social limits which were necessary to constrain the NHS. Outdated philosophies of ‘doctor knows best’ are being challenged by patients who have become used to the higher standards of service and respect offered by other consumer-orientated industries.