Managing diabetes, managing medicine

Chronic disease and clinical bureaucracy in post-war Britain

Martin D. Moore
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Through a study of diabetes care in post-war Britain, this book is the first historical monograph to explore the emergence of managed medicine within the National Health Service. Much of the extant literature has cast the development of systems for structuring and reviewing clinical care as either a political imposition in pursuit of cost control or a professional reaction to state pressure. By contrast, Managing Diabetes, Managing Medicine argues that managerial medicine was a co-constructed venture between profession and state. Despite possessing diverse motives – and though clearly influenced by post-war Britain’s rapid political, technological, economic, and cultural changes – general practitioners (GPs), hospital specialists, national professional and patient bodies, a range of British government agencies, and influential international organisations were all integral to the creation of managerial systems in Britain. By focusing on changes within the management of a single disease at the forefront of broader developments, this book ties together innovations across varied sites at different scales of change, from the very local programmes of single towns to the debates of specialists and professional leaders in international fora. Drawing on a broad range of archival materials, published journals, and medical textbooks, as well as newspapers and oral histories, Managing Diabetes, Managing Medicine not only develops fresh insights into the history of managed healthcare, but also contributes to histories of the NHS, medical professionalism, and post-war government more broadly.


‘Drawing on a wealth of primary sources, Moore details how local institutions, public health practitioners, and managerial bodies within the NHS interacted with one another within shifting political, economic, and cultural contexts. The first historical monograph to examine how diabetes became the subject of state-managed care, this well-researched book offers fresh perspectives on the history of medicine and is an excellent contribution to historiography. Summing Up: Recommended. Advanced undergraduates and above.
H. Caldwell, Chestnut Hill College
Choice Connect, Vol. 57, No. 2
October 2019

‘Managing Diabetes is an essential contribution to the history of medicine in Britain and will undoubtedly be of interest to both students and scholars of history, politics, medicine, and health pol­icy. Moore provides a fascinating history both of the NHS and the post-war management of chronic disease… Moore’s account is well-documented and engaging, and this particular history of diabetes is both compelling and imperative. Its insight con­tributes significant understanding of the rise of surveillance medicine, and the resulting responsibility and expectations placed on both patients and their practitioners evident today.'
Journal of the American Institute of the History of Pharmacy
January 2020

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