In the current phase of restricted finance, if managers and decision-takers are not going to be content to resign themselves to holding a completely defensive line, but instead will be required to look at the whole range of strategic issues at national, regional, and area level, involved in restricted resources and to develop tactical moves to rationalize services to achieve the optimum from such resources as are made available to them, an increased premium will be called for.
The need for the kind of framework and mechanisms for action and operation are indicated in the first three of the contributions to this volume. Dr Stone's essay indicates the indivisibility of curative and preventative medicine (or personal and population medicine) in the modern state, in which public policies for health are pervasive realities affecting education as well as professional attitudes and operational systems, in areas well beyond that of the NHS.