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The article by Professor Stephenson on the status of the NHS is based on three measures: that more money is spent on the NHS, that larger salaries are given to workers and that waiting times are reduced. Achievement of these measures gives a false view of the status of the NHS. Although there was some improvement in the delivery system of health care, it in no way matched the increase in expenditure which then highlighted the inefficiencies of many Trust boards who suddenly found themselves in charge of hundreds of millions of pounds of public funds. To illustrate the point you need to study actual cases, where the misuse of systems has resulted in reduced quality of care for children. We know that the reduction in waiting lists may be genuine in some Trusts, but in others it only reflects the manipulation of lists where patients are not included unless they are going to be seen by the target date. The status of child health is far from expectations and children are being denied access to existing services in order to reduce costs. In addition, the system of accountability has grave limitations.1 Other roles of the NHS are education and research. However, we are no longer allowed to take on fellows for education and the amount of research being carried out has seriously declined. It appears that while the nation is trying to make patients, and in our case the child, the focus of care, this is not universally the case. We would like to be proud of our NHS but this is sometimes very difficult!
Competing interests: None.