. Wood, ‘Policy emergence and policy convergence: the case of “Scientific-Bureaucratic Medicine” in the UnitedStates and United Kingdom’, British Journal of Politics and International Relations , 4:1 (2002), 1–21; S. Harrison and W. I. U. Ahmad, ‘Medical autonomy and the UK state 1975 to 2025’, Sociology , 34:1 (2000), 129–46; Flynn, ‘Clinical governance and governmentality’, pp. 155–6, 159–60; Kirkpatrick et al., The New Managerialism .
22 R. Klein, ‘The crises of the welfare states’, in R. Cooter and J. Pickstone (eds.), Medicine in the
, global health agencies (such as the WHO), and growing policy communities also help to explain similarities. 38 Yet the character of management in different countries also reflects differences in the structures, politics, and cultures of medicine across nation-states.
In the USA, for instance, multiple groups contributed to concerns about costs of healthcare in general, and chronic disease in particular. Hospitals, organised medicine, politicians, and federal and state government bodies were not the only actors in US health policy. Post
provision and professional self-management sat at the heart of all such activities, with the hope that self-regulation could bring expenditure under greater control.
Neoliberalism, welfare reform, and the management of British medicine
Political concerns about the relationship between clinical decision-making and resource use continued after the election of Margaret Thatcher in 1979. Comments from parliamentary select committees during this period indicate that traditional fiscal conservatives and social democrats were united in
, it had recalled, were devised to facilitate comparison between health districts, but ‘Scottish health boards were too diverse for comparison between areas’. Thus the authors suggested that longitudinal measures for ‘all Scotland’ would be preferable, and ‘access measures for the process of care’ could allow for intra-area comparison. As for the metrics to be chosen, the report drew on American suggestions, with the UnitedStates National Diabetes Advisory Board proposing ‘five major indicators of the quality of care’: visual impairment, perinatal morbidity and
Health and the Risk Factor: A History of An Uneven Medical Revolution (New York: University of Rochester Press, 2003).
115 G. M. Oppenheimer, ‘Profiling risk: the emergence of coronary heart disease epidemiology in the UnitedStates (1947–70)’, International Journal of Epidemiology , 35:3 (2006), 720–30.
116 Porter, ‘From Social Structure to Social Behaviour’; Elliot, ‘The prevention of illness in middle age’, p. 318.
117 Berridge, ‘Medicine and the public’; J. Hand, ‘“Tucking your tummy in
. Foucault, Discipline and Punish: The Birth of the Prison , trans. A. Sheridan (London: Penguin, 1991 ).
3 S. Timmermanns and M. Berg, The Gold Standard: The Challenge of Evidence-Based Medicine and Standardization in Health Care (Philadelphia: Temple University Press, 2003).
4 H. Marks, The Progress of the Experiment: Science and Therapeutic Reform in the UnitedStates, 1900–1990 (Cambridge: Cambridge University Press, 1997). See also discussions of ‘networks’ and ‘systems’ in W. E. Bijker, T. P. Hughes, and T
35 Pike, ‘A general practitioner looks at diabetes’, p. 169.
36 Ibid., p. 168.
37 Ibid., pp. 167–8.
38 Ibid., p. 165. On associative prediction vs causation: G. M. Oppenheimer, ‘Profiling risk: the emergence of coronary heart disease epidemiology in the UnitedStates (1947–70)’, International Journal of Epidemiology , 35:3 (2006), 720–30, esp. pp. 725–7.
39 On Darbishire House: M. Perry, ‘Academic general practice in Manchester under the early National Health
-sponsored by the New York
Academy of Sciences, the Hastings Center and the Royal Society
of Medicine.28 During a planning meeting, members of the British
organising committee, which included Gordon Dunstan and Sir
Douglas Black, had suggested that an ‘interesting and fruitful’
approach would be to look at ‘topics that reveal differences between
The making of British bioethics
the UK and USA’.29 Staff at the Hastings Center claimed that discussing the ‘marked differences’ between Britain and the UnitedStates would ‘foster an understanding and mutual appreciation
UnitedStates of America into the war in April
1917, although numerous trained American nurses offered their services to the French and Belgian Red Cross Societies and were engaged
in ‘front-line nursing’ from 1914 onwards, and a small number of
‘official’ American units also travelled to France.
Members of the army nursing corps of allied nations saw themselves as belonging to elite units. Trained in the most prestigious
nursing schools of their day, they carried with them a remarkable degree of confidence and self-belief, and their achievements
were eagerly reported
virtually unmodified (Table 8.1 ).
Vaccine schedules in Japan and the UnitedStates,
Japan UnitedStates Diphtheria Diphtheria Pertussis Pertussis Tetanus Tetanus Polio (OPV) Polio (IPV) Measles Measles Rubella (offered only to adolescent
girls before 1994) Mumps Japanese encephalitis Rubella BCG Hepatitis B