Healthcare must be built around patients, not profits

Patients are continually let down by health services that aren’t built around their needs. Inertia or the challenge of delivering change may mean that services are stuck in their old ways. For instance, patients in England face unnecessary risks because cosmetic surgery can still legally be performed by doctors without specialist surgical qualifications (doi:10.1136/bmj-2026-100528).1 Royal colleges, specialist surgical associations, and patient safety organisations have asked ministers to close this “serious regulatory gap,” a year after the government promised to take action.And clinicians working in orthopaedic services continue to overlook domestic violence injuries, despite training being available to help staff recognise indicators of abuse, even subtle ones. Improving the recognition and response to domestic violence would, Shady Hermena argues, require “minor structural adjustments to current service models” in orthopaedic centres (doi:10.1136/bmj-2026-100494).2Patients may be let down by services not shifting quickly enough to meet changing needs. James Parsonage and colleagues argue that…