Lloyd Davis, World Health Care Blog, March 12, 2008
This summarizes the talk by Niall Dickson, of the Kings Fund charity, UK, at this year's WHCC 2008 Europe.
A new dispensation - at the time of the creation of the NHS in 1948 the response from the public was gratitude and a huge welcome, but no real expectations of what it would provide and what universality of provision would really look like. One size fits all was accepted and at the same time doctors knew best. It seems that deference and placebo were key to medical practice.
But the world has now moved on with the creation of the notion of a consumer culture and customer influence, we all have expectations of being listened to but you won’t necessarily find it in care homes or in out-patient departments.
There has been a challenge to professional dominance in the UK especially after a number of scandals, Shipman, Bristol, Neal and there is a general loss of public trust in experts. Together with the arrival of the Information Age this all means that patients and service users question more and accept less. We have to accept that access to information will not be equal though and this is primarily seen as an age-related difference.
We are in the age of choice, we use it as voters and as consumers - and we’re losing the idea that vulnerable people can’t make choices for themselves. Yet we have a system that denies choice. People think they should have more choice than they currently do. Women more pro-choice than men and the assumption that choice is a middle-class privilege is challenged by the evidence.
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