Abstract

In recent decades, there have been major developments in health care and substantial improvements in clinical outcomes. However, there is still some way to go before we can say with confidence that all of our patients receive optimal care within our constraints of knowledge, technology and resources. In all health care systems, there is an unacceptable variation in care and, in many specialties, a lack of patient focus. This is particularly true for endoscopy, a diagnostic service that has evolved in a haphazard way, often in the backend of hospitals, and with insufficient planning to cope with new procedures and techniques, the burden of decontamination legislation and the huge expansion in demand.

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