Challenging the Citadel: Breaking the hospitals’ hold on the NHS: Challenging the Citadel: Breaking the hospitals' hold on the NHS

The authors argue that the NHS is far too focused on the hospital as an institution. The challenges of the 21st century require an NHS focused on public health and health prevention, but this will not be possible if the dominance of the hospital is not challenged.

Voters must find it confusing to see a Labour government being attacked by David Cameron for ‘NHS cuts’ and accused of presiding over a funding crisis in the health service. News reports talk of hospital trusts in financial meltdown, yet NHS spending will be £92 billion by 2007/8, almost triple what it was in 1997. What is going on?

Challenging the Citadel argues that the problem with the NHS is that it is far too focused on the hospital as an institution. The new NHS should be about public health and health prevention, and if the dominance of the hospital continues we will find ourselves unable to make substantial improvements in health outcomes and the NHS will be ill-equipped to cope with the pressures it will face in the 21st century.

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