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The authors reflect on the effectiveness of independent treatment centers which have been developed by Great Britain's National Health Service. They suggest that there is no definitive evidence which supports the continued funding of the centers. They argue that concerns from patients, lawyers and healthcare professionals about the quality and safety of the centers are being ignored by the government.

Focuses on Great Britain's National Health Service (NHS) and the Health and Social Care Bill of 2003. Definition of foundation trusts; How the secretary of state is obligated to promote a comprehensive, free health service to improve the health of the people; Problems of the inequity increasing through local generation of income.

The new research governance strategy marks a radical overhaul of the arrangements for medical research in the NHS and academic institutions with far reaching implications for all those taking part in research. As part of the reforms to NHS research and development strategy announced in 2000, the Department of Health published a research governance strategy for England. Care organisations must ensure that all research on NHS patients, their tissue, and their data, as well as research on NHS staff and research carried out in NHS premises, is conducted according to the framework. Research governance imposes new duties of care in the education and training of researchers and monitoring of research that have considerable financial implications for all organisations hosting research.

Abstract Objectives To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotland. Design Comparison of projected and actual trends in acute bed capacity and inpatient and day case admissions in the first five years (1995-6 to 2000-1) of Lothian Health Board's integrated healthcare plan. Population study of trends in bed rate, hospital activity, length of stay, and throughput in Lothian hospitals compared with the rest of Scotland from 1990-1 to 2000-1. Main outcome measures Staffed bed rates, admission rates, mean lengths of stay, occupancy, and throughput in four adult acute specialty groups in 1990-1, 1995-6, and 2000-1. Results By 2000-1, rates for inpatient admission in all acute, medical, surgical, and intensive therapy specialties in Lothian hospitals were respectively 20%, 6%, 28%, and 38% below those in the rest of Scotland. Day case rates in all acute and acute surgical specialties were 13% and 33% lower. The proportion of delayed discharges in staffed acute and post-acute NHS beds in Lothian hospitals exceeded the Scottish average (15% and 12% respectively; P < 0.001). Conclusion The planning targets and increase in clinical activity in acute specialties in Lothian hospitals associated with PFI had not been achieved by 2000-1. The effect on clinical activity has been a steeper decline in the number of acute beds and rates of admission in Lothian hospitals compared with the rest of Scotland between 1995-6 and 2000-1. [ABSTRACT FROM AUTHOR]

Discusses the use of private finance to build National Health Service (NHS) hospitals in Great Britain. Idea that private finance initiative (PFI) brings no new capital investment into public services and is a debt which has to be serviced by future generations; Topic of a value for money assessment, costs of PFI, and risk transfer; Assertion that PFI more than doubles the cost of capital as a percentage of NHS trusts' annual operating income.

Focuses on independent nursing homes for the elderly in Great Britain. Examples of poor care in privatised nursing homes in the United States and Australia; Question whether the regulatory framework for nursing home in Great Britain offers adequate protection for patients; Suggestion that regulators, public bodies, and private providers must be directly accountable to the public and service users to ensure quality care.

Discusses the reasons why private finance is moving primary care into corporate ownership. Reasons for the establishment of the National Health Service (NHS) of Great Britain, to integrate primary care and health and social services in health centers; How the aim was compromised by the absence of public capital and the reluctance of the Treasury to buy out practice premises owned by general practitioners; Question about the extent to which planning, population needs and accountability are incorporated into the procurement process.

Addresses concerns in the United Kingdom of whether primary care trusts leads to United States-style health care. Ability of a National Health Service (NHS) body to charge for personal care and hotel costs; How government guidance on intermediate care restricts entitlement to NHS care to six weeks except in exceptional circumstances; Details of the incentive structure of the new system, which will force care trusts to find ways of constraining expenditure through rationing, user charges, and commercial activities.

Discusses issues on Britain's private finance initiative and the National Health Service (NHS). Arguments on the private finance initiative; Cost of the third wave of private finance initiative hospital schemes on planned private sector investment in the health service; Condition of creating alternative sources of funding with the NHS. INSET: Summary points.

Assesses the challenges of devolution on public health Wales and Scotland. Structure of the assemblies and their powers; Inequalities in health and wealth in both countries; Overview of public health in both countries; Party policies on health services.

Argues against local authorities taking over the British National Health Service. Shift from the public to private sector provision; Capping public sector spending; Removing publicly financed services from public control.

Cites a study which investigated the relationship between deprivation and emergency admission for cancer in south east England. Associations between social deprivation and cancer survival; Reorganization of cancer services in England and Wales. INSETS: Data on finished consultant episodes retrived from the Office...;Therapeutic and palliative surgical procedures;Key messages.

Discusses the advantages and disadvantages of the proposed privatization of hospital services for the British National Health Service. Case studies under the private finance initiative; Determination of bed numbers; Interpretation of trends in bed availability.

Presents several letters on medical care in Great Britain. Impact of local managerial target setting in achieving improvements in health; Specification of the cut off point used in quoting years of life lost; Efficacy of using fluoxetine in suicidal patients .

Examines the factors affecting the outbreak of food poisoning caused by Clotridium perfringens in hospitals. Emphasis on the quality of care; Importance of high standards of ancillary provision in preventing outbreaks of food poisoning; Reasons for the outbreak of food poisoning in hospitals.

The article focuses on the UK Department of Health's "Best Research for Best Health," a report which sets up an organizational and funding framework for National Health Service and associated university medical schools in England. The report outlines the implementation of a National Institute for Health Research, which will centralize governance, staff, facilities and infrastructure needs of medical research.

Discusses new community care regulations which mean that older people may not be able to choose where they are treated. Claims of improvement of access to health care for poor and disadvantaged by health secretary John Reid versus the Community Care (Delayed Discharge) Act which comes into force in January 2004; Details of the Community Care Act; The possible undermining of the 1948 National Assistance Act, known as the Direction on Choice.

Reports on the supposed resolution of the issue of giving poor countries access to essential medicines without breaching laws on intellectual property by the World Trade Organization (WTO). Past agreements; Allowance of drug companies to charge monopoly prices for essential drugs; Provisions for over-riding of patent protection for public health purposes; 2001 declaration stating the WTO's intention of finding an interpretation that squared the interest of pharmaceutical industries and poor countries; Description of the deal as a historical agreement by WTO director general Supachai Panitchpakdi; Grounds for scepticism; Basic problems with trade related aspects of intellectual property (TRIPS); Questions from the United Kingdom Commission on Intellectual Property Rights and Development Policy.

Discusses a decision by the United Kingdom's Competition Commission that could make all contracting out and commissioning of health care by N.H.S. and social services subject to European Union competition law, rather than a matter for national public health policy. Tensions between the European Union's economic constitution and national control over healthcare policy because of healthcare reforms; Judgment by the United Kingdom tribunal that shows how the courts are moving the dividing line between economic and social activities; Implications of the judgment.

Discusses the choice extended to patients to choose among public and private health providers in Great Britain. Effort of Great Britain's National Health Service to engage more constructively with private sector; Implications for national control over health policy; Role of Great Britain's National Agreement on Trade in Services; Failure of Great Britain to protect its health policy.

Editorial. Discusses the decision by the Scottish government regarding how long term medical care challenges the National Health Service (NHS) of Great Britain. Reasons why the Scottish Executive decided not to charge elderly people for personal and social care, and how the decision impacts one made by the United Kingdom's Westminster government; Details of the decision; How Scotland has the lowest life expectancy and highest all cause standardised mortality ratio in the U.K.

Editorial. Discusses the funding of the intermediate care plan proposed by Great Britain's National Health Service (NHS). Details of the budgets of care trusts for the delivery of community health care and social care; Questions regarding the NHS definition of nursing care; Impact of altered funding mechanisms on health care quality in Great Britain.

Discusses the advantages and disadvantages of community oriented primary care as a method of teaching and applying public health skills in Great Britain. Description of King's Fund pilot project; Factors for needs assessment; Support for health authorities.

Focuses on significance of public opinion to the people running the National Health Service (NHS) in Great Britain. Opinion of National Association of Health Authorities and Trusts on public consultation; Implications of threats to health services on NHS; Processes affecting the central tenets of NHS.

The article discusses three reports on the future of medical care in Great Britain namely, "Future Direction of Health Care," from the National Association of Health Authorities and Trusts, "Future Health Care Options," released by the Institute of Health Services Management and the survey of health policy makers. The first paper focused on how the National Health Service (NHS) deliver health care in the nation. The second report gave out suggestions for medical care such as social insurance and local taxation.

Evaluates 'Local Voices,' a publication of the National Health Service (NHS) Management Executive. Emphasis on the consumerism in health service; Presentation on the democracy of the consultation process of NHS; Discussion on the ministerial management of health care.

Editorial. Discusses the introduction of capital charges to National Health Service (NHS) in Great Britain. Introduction of the charges in 1992; In-depth look at the NHS trusts; Assessment of the NHS trusts' performance; Value of NHS assets.

This article presents a letter to the editor in response to the article "Evidence not ideology," by Godlee that appeared in the October 8, 2005 issue of the "British Medical Journal."

Presents a response to a letter to the editor regarding the role of industry and higher education in medical research conducted by the British National Health Service.