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© 1995 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom

article-commentary

Clinical and economic consequences of patients as producers


Julian Tudor Hart, Retired general practitioner; Research Fellow, University of Glasgow Department of General Practice; Visiting Professor, Department of General Practice, Royal Free Hospital

Gelli Deg, Penmaen, Swansea SA3 2HH

NHS market ‘reforms’ and the world-wide drift toward managed competition in health services rest on a fundamental misunderstanding of the nature of health production through medical and nursing care. Optimally efficient health production depends on a general shift of patients from their traditional role as passive or adversarial consumers, to become producers of health jointly with their health professionals, in an essentially co-operative rather than competitive public service.


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