Competition between systems for pride is effective and essential

Sir Muir Gray blogging on the BMJ site: “Competition, like all medical care, can do harm as well as good. Competition between “providers” on hospital criteria such as compliance with…

Sir Muir Gray blogging on the BMJ site:

“Competition, like all medical care, can do harm as well as good. Competition between “providers” on hospital criteria such as compliance with standards, appears to do more good than harm, though quality improvement too can have unintended consequences. What is needed are population based systems competing on value, on outcome, and cost. The issue of cost cannot be avoided because if resources are used and produce low, or no, value it is not the tax payer who pays but those other patients whose needs could have been met with that wasted resource, and there is evidence that this type of competition works…