Political Exhortation, Patient Expectation and Professional Execution: Perspectives on the Consumerization of Health Care

Abstract

A central theme underpinning the reform of public‐sector services in western economies since the 1980s has been the emphasis on reorienting service provision around the user. Public‐sector organizations have been forced to reappraise the design of the service delivery process, in particular the service encounter, to take account of the resultant changes in service users’ expectations. Such focus on the service user has fundamental implications for public‐sector professionals, specifically challenging the dominance of service professionals in the design and delivery of services. Based on a survey of patient attitudes towards service provision in the National Health Service in Scotland (NHSiS) and in‐depth interviews with senior hospital clinicians and managers, the paper critically examines the reaction of both patients and professionals to politically driven initiatives to reorientate the delivery of health‐care services. Specifically the paper explores the emerging perspectives of both patients and professionals towards the consumerization of health care and the changing nature of the relationship between patients and professionals within a publicly funded health‐care system.