ABSTRACT
The Thatcher government recognized that to reform the National Health Service (NHS) by privatizing doctors and hospitals would be politically unacceptable. Some elements of the reforms changed administrative practices in ways which pointedly repudiated the old ethos of the NHS and gave patients the status of consumers whose wants should be satisfied. The chain of command was hardly simple. It was certainly not what Aneurin Bevan had in mind when he assured a meeting at the London School of Economics in 1948 that the administrative costs of the NHS would be negligible. If Thatcherites decide that the NHS is 'safe in their hands', it is not because they stand in awe of it or regard it as a holy relic but because they consider it the most suitable arrangement for the current circumstances. Circumstances had exacerbated the consequences of the NHS fallacy.
