Place, Space and Reputation: The Changing Role of Harley Street in English Health Care

Abstract

Harley Street has longstanding iconic status in England as the centre of elite private health care. Celebrated by its advocates and notorious among its critics, its name remains the standard synonym for private medicine in all public discourse on the subject. In this paper, adopting Gieryn's concept of ‘place' as a bundled combination of three features (location, material form and invested meaning), I explore the significance of Harley Street as a place and idea, seeking to understand how both aspects have been affected by changes over time in the wider arena of health care and how both, in turn, have influenced that wider world. Analysis of the identity of its professional occupants, their patterns of practice and relations with their patients is used as a focus to explore continuity and change in the nature of, and relationships between, public and private practice, orthodox and alternative therapies, medical knowledge, health policy and wider social change. I conclude with some thoughts about Harley Street's enduring influence on the national health service.