Why hospitals must be allowed to fail

摘要

In St Paul's cathedral there is an epitaph to Christopher Wren, the 17th-century architect who rebuilt it after the Great Fire: "Si monumentum re-quiris, circumspice". Tony Blair wants the National Health Service to be his St Paul's: those who seek a monument to his premiership should need only to look at Britain's health-care system. Yet the odds that health-care reform will prove the imposing legacy the prime minister longs for are lengthening by the day. There is an unmistakable whiff of political panic as the nhs lurches from one crisis to another. On March 7th, Sir Nigel Crisp, its chief executive since November 2000, abruptly announced that he was taking early retirement. There is little doubt that Sir Nigel has paid the penalty for a series of financial reverses and managerial mishaps. Yet disruption is the inevitable consequence of reform; and if the government loses its nerve, reform will come to a full stop and Mr Blair will have no monument.