The pelvic ileal reservoir: apocalypse later?

failure has been moulded by bureaucratic constraints, so that it is different in both scale and strategy from those in other relatively prosperous countries. It is also slow to respond to medical advances, which may need extra resources to make them equally available to all who could benefit, such as recombinant human erythropoietin for patients undergoing dialysis. Will the new methods of NHS funding to be introduced in 1991 change the pattern of the programme? Money that follows patients is said to make bureaucratic logjams simpler to resolve,20 and it could provide an incentive for opening new renal units. The wishes of patients and the costs of transporting them to thrice weekly treatments both point to the desirability of increasing the numbers of renal units and specialists to fill geographical gaps in provision.