Non-controversially, the full version of this article argues that the crisis in British higher education will impoverish teaching and research in the arts and humanities; cut even more deeply into these areas in the post-1992 sector; and threaten the integrity of every small sub-discipline, including the history of medicine. It traces links between the Thatcherite reforms of the 1980s and the near-privatisation of universities proposed by the Browne Report and partly adopted by the coalition. The article ends by arguing that it would be mistaken to expect any government-driven return to the status quo ante. New ideas and solutions must come from within. As economic and cultural landscapes are transformed, higher education will eventually be rebuilt, and the arts and social sciences, including medical history, reshaped in wholly unexpected ways. This will only happen, however, if a more highly politicised academic community forges its own strategies for recovery.