Abstract
News p 650 Reduced waiting lists for NHS hospital treatment was one of the five main promises Tony Blair made to the British electorate before his election. Last week we learnt that since he came to power the numbers waiting have increased by 100 000. The time has surely come for the government to acknowledge the inevitability of rationing health care and to shift the debate on the NHS to something more important than numbers on waiting lists. Even on waiting lists, there is scope to copy New Zealand and do a better job of managing them. Britain experienced a disorientating period of optimism after last May's election. Many sensible people, including observers of the health service, deluded themselves into thinking that all would be different. Old problems would be solved and a new Britain—and a new health service—would emerge. In fact most problems, including those of the health service, are deep rooted and not easily solved. Furthermore, the seemingly unstoppable process of globalisation means that economies are controlled by international economic forces and governments have ever less room to manoeuvre: they have to occupy a middle political ground whether they like …

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