Abstract

The patient consumer currently occupies a central position in attempts to reform Britain’s National Health Service.  Framed around the introduction of greater ‘choice’ and ‘voice’ for patients, individuals are being called upon to act as consumers within an increasingly marketised health system.  But where did this notion of the patient as ‘consumer’ come from, and to what extent did this come from patients themselves?
 
This paper will examine the work of a number of groups that claimed to speak and act for the patient as consumer during the 1960s and 1970s.  Organisations such as the Patients’ Association, the Community Health Councils and the Consumers’ Association were all interested in the idea of consumerism within health.  For some patient groups, consumerism was a way to enhance individual and collective participation in healthcare.  For others, consumerism was about ensuring that patients’ rights were respected.  Consumerism was thus a way of attending to the needs of patients as well as the patient.  However, by the late 1980s, the Conservative government began to adopt and adapt the idea of the patient-consumer, and emphasis switched from the collective and towards the individual.  Patient consumerism came to be associated with individual choice, rather than health for all.
 
By exploring some of these issues this paper will highlight key changes in the meaning of patient consumerism over time, but also ask questions about where such identities were constructed and given authority.  It will suggest that both the state and civil society need to be taken into account when examining the significance of contested concepts and identities.