Across the globe, health care in the 21^st-century remains a cottage industry: fragmented, inefficient, duplicative, patchy in coverage, highly variable in terms of outcomes for patients, misaligned to the emerging patterns of disease, acutely political and potentially dangerous. The truth is that the traditional models of healthcare are no longer fit for purpose, and no healthcare system in the Western world is financially sustainable in its present form for much longer. What are the political, technological and cultural transformations that will be necessary to resuscitate the patient? England’s national health service (the NHS) is the largest single system in the world, with a budget of over US$150 billion and 1.3 million employees. Its commitment to providing care for all, free at the point of need, is coming under huge financial pressure. What needs to be done, and what are the lessons for – and from – global health care?

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