Observations Life and death

The growing gap

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39164.469815.47 (Published 29 March 2007) Cite this as: BMJ 2007;334:670
  1. Iona Heath, general practitioner
  1. London
  1. iona.heath{at}dsl.pipex.com

    The collusive relationship between the state and the market is at odds with the promotion of free choice for patients

    A teacher once told me that it was the experience of enduring the dying days of communism in Poland that enabled him to recognise the obsession with regulation and control within the New Labour state education system. Perhaps similar experiences explain the insights of another Polish exile, Zygmunt Bauman, the emeritus professor of sociology at Leeds, who has described “a growing gap, indeed a contradiction, between values promoted in public discussion and those whose cause is served by political practice.” It is not difficult to recognise this description within New Labour's version of the National Health Service.

    Public discussion is directed towards the worthy aspiration of improving services for patients. Patients' views are given a central place within official rhetoric. Glossy NHS publications are now routinely illustrated by pictures of contented and attractive patients being cared for in optimal surroundings. Professionals are instructed to provide both “choice” and “patient centred care.”

    Yet, on the far side of the gap, we have the accelerating privatisation of healthcare provision, for which there is no electoral mandate, and a …

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