The role and education of doctors in the delivery of health care*

Abstract

The demand for health care is rising but the financial and personnel resources available to the UK National Health Service (NHS) are failing to keep pace. Three paradoxes are now apparent. First, because of the advances in biomedical science and technology, we have never been able to do so much for our patients as we can now, but rarely, it seems, have doctors been so criticised. As Roy Porter pointed out in his recent history of medicine, 1 Porter R The greatest benefit to mankind: a medical history of humanity from antiquity to the present. Harper Collins, London1997 Google Scholar few people today feel confident about their personal health, about doctors, about health-care delivery, or about the medical profession in general. The second paradox is that we have never spent more on health care, at least in more developed countries, but we have never seemed so short of resources to meet unmet need. Third, in more developed countries, despite the increase in longevity, there is still a high prevalence of disease and disability.