ABSTRACT
To counter some of the public scepticism and help take medicine into the twentyfi rst century, proposed changes in healthcare are under way in many countries, including Britain. According to Lord Crisp,216 former chief executive of the NHS and Permanent Secretary of the Department of Health (2000-06) and a Lancet report commissioner,56 ‘[t]he biggest need and the biggest cost is to provide continuing help for older people with long-term conditions to look after themselves, manage intermittent crises and maintain their health and independence’. As things stand, he advises, ‘the NHS is still a service that is geared more towards one-off episodes of hospital treatment than to providing community support. Both are needed but the balance has to change.’
