ABSTRACT
The NHS is one of the great developments of humankind. It reflects the ability of a society to provide healthcare for its citizens irrespective of their wealth and irrespective of their standing in society. Its immense strength is in its universality and accessibility. The patient expectations, hopes and aspirations have increased which may be stressful for the service. Medicine needs to be done with patients, not to them, so a key shift has to be true partnership. The under-investment in the National Health Service workforce has been a major problem in the last few decades. It is important to look at the boundaries of healthcare as well as the reality of patient and societal expectations as sometimes these get muddled. It is also worth recognising that the NHS cannot do everything, and the society has to take on board this imbalance between infinite demand and finite resource. Models from other countries need to be looked at, but it is important to recognise that there are no universal answers. The more equal a society is, the happier it is. In order to do so, a major step forward is to get rid of the inequalities.
