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The need for health systems education during medical training in the UK
  1. Jessica Lee1,
  2. Emiliano Valle2
  1. 1 School of Medical Sciences, The University of Manchester, Manchester, UK
  2. 2 Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Jessica Lee, School of Medical Sciences, The University of Manchester, Manchester M13 9PL, UK; leejessieanne{at}

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Healthcare professionals are uniquely placed to understand human suffering. They have the daily responsibility of witnessing it and attempting to halt it. However, the ways in which healthcare systems and wider social structures impact this suffering are seldom taught in a comprehensive manner to medical students in the UK. The UK’s National Health Service (NHS) makes fundamental decisions (eg, what drugs to purchase, where to allocate funding, how to pay medical personnel) that powerfully impact human health. Students entering this system as trainees deserve to be properly educated in how it works.

Since its inception in 1948, the NHS has provided all Britons with universal access to healthcare.1 Yet, despite this free access at the point of care, entrenched socioeconomic inequities prevent health needs from being fulfilled; the greater the deprivation of an area, the poorer the outcomes, the more complex the health problems, and the higher the mortality and morbidity rates.2–8 Universal access to care alone is not ensuring that deprived populations have their health needs met, and there is a clear discrepancy between resource allocation and need across the socioeconomic spectrum.2 3

Resource allocation in the UK is a centralised and highly political process. Nevertheless, clinicians play an increasingly prominent role in local distribution.9 Since 2012, clinical commissioning groups have been in charge of locally apportioning centrally divided sums, to allow for greater responsiveness to specific population needs.9 With increasing recognition of the roles that general practitioners and consultants (senior hospital physicians) are performing in both the allocation of resources and service …

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  • Contributors JL and EV planned, researched and wrote the content of the article jointly.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.