Acute diarrhoea in adults

Firstly, the planners, the economists, the actuaries, and the lawyers have to sit down with tne doctors and devise a new format, shorn of expensive bureaucracy, which is more efficient, competitive, and, in the long run, cheaper. This then has to be sold up-hill to those who will fear losing their mess of pottage in any transition, and this would obviously mean many of the senior doctors approaching pensionable age. Adequate provision for full-time academics and research workers has to be worked out. At the same time the public has to be convinced that the new system would be a better method of providing medical care. Supervised competition means good and prompt service. The patient is much more in control than the civil servant administrators. The public also have to be shown that those in true need would be adequately subsidised. Finally, and perhaps most difficult of all, the profession must be convinced to unite behind the idea of such an organised system of national health insurance and behind one organisation as their leader and spokesman. Should these steps be achieved, the politicians will follow. The work involved, the amount of persuasion needed, the quality of leadership demanded are obviously far greater when one has to change the direction of a system already well entrenched than if one is building anew. Whether the British profession wish to consider this or to pursue their present course is nothing to do with a Canadian commentator, but only when such a viable alternative is hammered into shape and is available to most of the British public will the medical profession truly be at the crossroads.