Since the 1960s, patients in Britain have been made into consumers.
Consumerist concepts have found a place in health policy and practice.
Ideas like autonomy; collective and individual representation; the ability to
make a complaint; rights; the provision of information; voice and choice are
now central to the National Health Service (NHS) and the demands patients
make of it. Over a few decades, the position of patients in Britain appears
to have changed fundamentally. During the early 1960s, for example, it was
not uncommon for patients to be told
1.1a Jason straight after surgery.
Surgeons say results look best ‘on the
1.1b Jason’s complication – a ‘little
bleed’ and ruptured stitches
1.1c Jason’s infection needed vacuum
pump treatment in an NHS facility
1.1d Jason’s final result, front
1.1e Jason’s final result, side
1.2 Neil (UK to Czech Republic and
Poland) demonstrating what he called
his ‘mushroom’ after weight-loss
surgery but before body contouring
HOLLIDAY PLATES (Colour).indd 1
1.3 A bedside table in a Tunisian clinic
1.4a Durian street-seller in front of a
Projects like the SMD-funded retinopathy screening trials reflected the British state's growing engagement with diabetes during the 1980s. In that specific instance, the DHSS's hopes for generating organisational guidance for the NHS were disappointed. Central state interest in diabetes management, however, remained undimmed, and much more extensive standards for diabetes care would be produced by the new millennium.
The work of elite practitioners and specialists proved integral to maintaining state interest in both
In April 1990, the Conservative government issued a new contract to general practitioners (GPs) working within the British National Health Service (NHS). The negotiations around the contract had been troubling for GPs. Whilst not the sole point of dispute, many practitioners found novel performance-related pay provisions to be particularly unwelcome departures from previous arrangements. Despite gaining concessions, GPs rejected multiple offers until a frustrated administration decided to simply impose the contract. 1 So far as remuneration
The Emergency Hospital Services in Second World War Northern Ireland
Emergency Medical Services – and allied services
including medical services, a casualty bureau, blood transfusion and
pathological service. This wartime reorganisation of health services
has been viewed as vital to paving the way for the universal,
centralist and free-at-the-point-of-contact National Health Service
(NHS) that came into effect in 1948, and for specifically providing
The medical Left and the lessons of science, 1918–48
‘Man against disease’: the medical
Left and the lessons of science,
This chapter examines the ideas and aspirations of left-wing doctors and medical scientists from the end of the First World War to
the inauguration of the National Health Service (NHS) in 1948.
There were four underlying premises to these medical politicians’
social and political analyses. First, scientific and medical practice
provided a model for social organisation. Doctors and medical
scientists, it was argued, worked collaboratively and irrespective
The working lives of paid carers from 1800 to the 1990s
Anne Borsay and Pamela Dale
over meeting the needs of local people requiring mental health services.41 Unfortunately, they had little to say about how nurses adapted
to the possibilities and constraints embodied in this new facility, but
at the Maudsley, and elsewhere, the contested introduction of new
physical therapies impacted on both the daily work and career prospects of mental nurses before and after the creation of the National
Health Service (NHS).
The increasing resort to physical therapies, such as insulin coma
or ECT, from the 1930s is associated with a requirement
record of his opponents on economic management by
saying they represented groups and policies that not only undermine economic
growth but subvert the values he articulated. He also critiqued his opponents’ ideological adherence to privatisation and the model of competition, saying ‘here’s what
I hate most of all. It’s that the whole way they designed this NHS reorganisation was
based on the model of competition that there was in the privatised utility industry,
gas, energy and water’ (Miliband, 2012). In fact, he goes on to blame such interest
groups for the flaws in
6 See, for example, Amanda Platell, ‘Sorry, why should the NHS treat people
for being fat?’, Daily Mail Online (27 February 2009), www.dailymail.co.uk/
fat.html (accessed 18 September 2016).
7 See, for example, ‘UN panel warns against “designer babies” and eugenics
in “editing” of human DNA’, UN News Centre (5 October 2015), www.
21 October 2016).
or more value-for-money than their rivals.
The National Health Service (NHS)
One of the most controversial public sector reforms enacted by the Conservative
led-Coalition was symbolised by the 2012 Health and Social Care Act, which
replaced ten strategic health authorities and 152 Primary Care Trusts (PCTs) with
consortia of general practitioners (GPs) or clinical commissioning groups. The
intention was to enable these consortia and groups to commission care packages
directly for their patients or local populations, rather than having to negotiate with