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Professor Stephenson raises many important issues with his rhetorical question, “is the NHS still something to be proud of?”,1 pointing out that children are among a number of vulnerable groups likely to find specialist services increasingly difficult to come by. Payment by results seems poised to bankrupt children's hospitals, and in my own Trust, from having been a net “earner” the paediatric department is now likely to produce a £16 million annual deficit. Needless to say, plans for the long awaited Children's Hospital for Leeds have (once again) been shelved. The popular view fostered by New Labour politicians, parliamentary committees and much of the media is that greedy doctors (large pay rises) and poor financial management go a long way to explaining why record investment seems to have achieved so little. As Professor Stephenson shows, this is not the whole story. The fact that the NHS is being quite deliberately dismantled through the process of “patchwork privatisation”, eloquently argued by Alex Nunn for the “Keep our NHS Public” campaign (www.keepournhspublic.com), is seldom mentioned. The prospect of a health service opened up to private companies beholden only to their shareholders is not what inspired many of us to become paediatricians. We can look forwards to a wasteful American‐style system of healthcare for those who can afford to pay. A broad and popular movement in defence of the principles on which the NHS was founded is the only way we might yet avoid being left to reflect dismally on the days of a comprehensive and equitable service as a vanished golden age. As Nye Bevan said of the NHS, “it will last as long as there are folk left with the faith to fight for it”. Professor Stephenson has thrown down the gauntlet.
Competing interests: None declared.