The conflict of evidence on the condition of the NHS is bewildering. The one thing that everyone agrees on is that it is impossible to judge how well it works.
Any report on the state of Britain's National Health Service in the 1990s will be a report on the state of the nation's soul. Straddling the fault-line between the welfare state and the enterprise society, central planning and the market, public and private, the discourse of care and the discourse of cost-effectiveness, the uncomfortable present and a simpler past, the NHS faithfully captures and amplifies the strains running through society as a whole. How otherwise can the baffling conflict of evidence over the current condition of British health care in general and the results of the 1991 reforms - as Margaret Thatcher boasted, 'the most far-reaching reform of the NHS in its 40-year history' - be explained?