“The doyen of evidence-based medicine, Professor Archie Cochrane (who died in 1988), was a medical student in london in the 1930s. There was a rally about the possibility of a national Health Service, and he decided to go. The official banner is said to have carried the slogan ‘all treatment must be free’. Cochrane constructed his own, which read ‘all effective treatment must be free’.
With its strong underpinning ethos of equity, its ability to make systematic policies and its non-profit foundations, the NHS has a unique opportunity to address the fundamental causes of inappropriate variation in treatments and treatment rates. Cochrane’s celebrated vision of the 1930s, that ‘all effective treatment must be free’, is not yet fulfilled. More than many other healthcare systems, which also experience such variation, the NHS can solve this long-standing problem.
For almost 60 years, the National Health Service has been the mainstay of healthcare provision in England. By any standards, it is a large organisation, employing 1.4 million staff, and the diversity of the activities undertaken is huge.”