ABSTRACT
In the 1960s, there was new concern about the attrition of UK-trained physicians who were migrating to North America and Australia in alarming numbers in search of higher incomes and better professional openings than they could secure in Britain. Much of the current debate about the National Health Service (NHS) is, indeed, about the effectiveness of its performance compared with that of other systems. In particular, it is argued that Britain's position in the league tables for infant mortality and for deaths from coronary heart disease, lung cancer, and other diseases, which are most likely to affect the middle aged, has worsened. Private medicine has always been permitted in Britain. NHS hospitals will, from 1990, be given an opportunity to acquire "Hospital Trust" status. A major innovatory proposal is that general practitioners with 11,000 or more patients registered with their group practice can, if they wish, become "Budget Holders."
