Quality and Safety

Abstract

This chapter focuses on questions of the quality and safety of health care. The science of medicine is closely focused on the personal care of patients. The quality movement in post Second World War industrial society analysed industrial manufacturing operations as social systems. Technologies of quality improvement proliferated, initially in manufacturing but also in service industries as these grew in economic importance. The policy-holders are paying private health insurance companies as the policy providers to finance their health care for them, and they want them to ensure that the services provided are of a high quality. The Medicare Benefits Scheme, also dating back to the 1950s but achieving universal coverage only in the 1970s, has been much slower to address quality and safety. The struggle of clinicians for the freedom to act in their patients’ best interests is transformed as they become drawn into giving accounts of the quality and safety of clinical care to each other and to management.