An Editorial published in The Lancet today [Friday 16 August] examines recent turmoil in the NHS, accusing the UK government of appearing to treat the NHS as a failing bank or business, based on recent headlines about NHS 'bailouts' and cost-cutting. According to the journal Editors, "This stance is one of the most cynical, and at the same time cunning, ways by which the government abdicates all responsibilities for running a health-care system that has patient care and safety at its heart."

The Editors implicate recent NHS reorganisation in creating a system where the state's responsibility to provide health services has become so fragmented that "The exact responsibilities are at best complex, not easily understood, and at worst deliberately obfuscated. Who exactly is leading and to what end is even less clear." While the Editors welcome the conclusions of Don Berwick's recent report, Improving the Safety of Patients in England, they warn that its recommendations will need to be taken seriously by the next Chief Executive of the NHS if they are to "have the slightest chance of turning around the NHS from its current path to a market commodity to its true purpose of a compassionate, free, equitable, and effective health system with patients' health, wellbeing, and dignity as its goal and top priority."

In a Comment published in the same issue, Professor Sir Brian Jarman, of the Dr Foster Intelligence Unit at Imperial College Faculty of Medicine, London, UK highlights the fact that despite extensive regulatory reorganisation in recent years, the NHS still has no official investigator of poor clinical care, and urges policy makers to introduce a number of measures to improve the quality of care in UK hospitals.

Amongst other recommendations, Professor Jarman suggests that Independent Review Panels (which formerly investigated patients' complaints about hospital services, before being abolished in 2004) and Community Health Councils should be reintroduced, along with a regular monitoring system for complaints, similar to the mortality alerts which ultimately led to the uncovering of the Mid Staffordshire hospital scandal. According to Professor Jarman, "There has been a decade of concerns about the quality of care in our hospitals: patients have been ignored, the regulatory systems have failed, and there has been a culture of denial. With political will the proposed reforms could lead to marked improvements."