‘We must accept that health care is a risky business’

One of the thorniest issues in the relationship between doctors and patients has been how to deal with a dispute. The rhetoric of the past few governments, both Conservative and Labour, has emphasised the need to treat patients as consumers of services provided by the NHS. Patients need to be “at the centre” of all arrangements for planning, delivery, and accountability. At the same time, the private healthcare system in Britain has grown by aggressively marketing its service as modern and responsive to patients' needs as “customers,” and patients are becoming used to making choices both about who provides their services and the nature of the treatment they are to have.

The growth in consumerism has been accompanied by an explosion in information systems, most notably the internet, which have made patients more knowledgeable customers when it comes to disease, treatments, and patients' rights. Recently, information on the performance of hospitals has become available through private initiatives such as the Good Hospital Guide,1 and the Department of Health plans to publish more detailed information on the performance of individual consultants.