Whatever suits you: unpicking personalization for the NHS

Abstract

In this paper we argue that policy calls for personalization or 'tailored' services derive a large part of their appeal from the way they 'fudge together' different things. Using the recent policy discourses surrounding personalization in the UK NHS as a case study we illustrate the policy 'work' that is accomplished by this vagueness and focus in on one important fudge - that between a health service tailored to people's medically defined needs and one tailored to people's wants. Our analysis highlights some of the fundamental philosophical and political questions that need to be addressed before personalization can take shape as a coherent policy option. We also highlight the potential scale of the implications personalization has for the welfare state and argue that such implications warrant greater discussion than is currently being afforded to them. We conclude that philosophical analysis is crucial for guiding the redirection of services implied by personalization discourses. The process of selecting and justifying the way in which the personalization agenda is advanced requires both an analysis of the relationships between needs and wants in human flourishing and an explicit reconsideration of the purpose of the welfare state.