Mental health, cancer care and coronary heart disease were identified as the three priorities for the National Health Service, and National Service Frameworks were developed for each area. This prioritisation was reinforced when the NHS Plan was published and a programme of systemic change in the National Health Service was embarked upon to support this new agenda.\ud \ud This paper describes the major policy decisions and systemic changes and how they affected mental health care. The end of the 10-year National Service Framework programme provides an opportune time to review and reflect on the changes, successes and areas for on-going improvement in the\ud years ahead. Clearly there have been significant developments, and perhaps the successes of the last 10 years have been lost in the clutter that often results as a consequence of major change
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