ABSTRACT
The history of the British National Health Service since 1948 has been a chronicle of a service in constant flux. In the face of long-standing problems of cost containment, resource allocation and service rationalization, successive governments have sought solutions through a variety of organizational reforms, including a major rejigging of the NHS structure in 1974. But, as in other Western health care systems, the difficulties have proved to be stubbornly intractable. The 1980s, far from marking a period of consolidation and equilibrium, have seen the pace of reform quickening as the interval between successive service reorganizations diminishes.
