The English NHS: from market failure to trust, professionalism and democracy

An extensive critique of the market conception of health provision, combined with a vision for an alternative way of running the health service. The failure of market 'reforms' cannot be addressed by tinkering with new models of provision. The 2012 Health and Social Care Act has not worked and needs to be repealed, especially considering that the Five Year Forward View, intended to circumvent the Act's inadequacies, has created even more problems. Other measures needed are the termination of for-profit provision of clinical services; a restoration of trust in health professionals; the replacement of audits and penalties by a pro-active system of democratic accountability; and a much greater prominence for public health. Finally, adequate funding is needed: no amount of innovation or efficiency savings could make up for the current gap between what is needed and what is funded.