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The authors argue that the initial settlement made between the state and the medical profession when the NHS was founded is changing and must change further. Any fundamental change within the NHS requires an adjustment to the NHS's implicit constitution, that is the balance of power between professionals, the state and the public, and this must start with the political role."]}],"service":[{"@context":"http://iiif.io/api/search/0/context.json","profile":"http://iiif.io/api/search/0/search","label":"Search within this manifest","@id":"https://archive.kingsfund.org.uk/concern/published_works/000023174/search"}],"sequences":[{"@type":"sc:Sequence","@id":"https://archive.kingsfund.org.uk/concern/published_works/000023174/manifest/sequence/normal","rendering":[{"@id":"http://archive.kingsfund.org.uk/downloads/723d951e-94a9-4d54-8979-207b2b2f1b94","format":"application/pdf","label":"Download whole resource: 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