We read Professor Stephenson’s excellent perspective on the state of the NHS with interest.¹ This is a very comprehensive account of the NHS budget, NHS reform and implications for children’s services. We would like to add a few points specific to the impact of the new NHS on the care of children, both current and in the future, due its effect on the training of new paediatricians.

Towards the end of the article, the important point is made that patient choice and plurality of providers may well not be the best solution for children with multiple coexisting long-term problems. We would like to add that there is also a real danger that the system by offering …