The National Health Service (NHS) officially ‘opened’ across Britain in 1948. It replaced a patchy system of charity and local providers, and made healthcare free at the point of use. Over the subsequent decades, the NHS was vested with cultural meaning, and even love. By 1992, the former Chancellor of the Exchequer Nigel Lawson declared that the service was ‘the closest thing the English have to a religion’. Yet in 2016, a physician publishing in the British Medical Journal asked whether the service was, in fact, a ‘national religion or national football’, referring to the complex politics of healthcare. Placards, posters, and prescriptions radically illuminates the multiple meanings of the NHS, in public life and culture, over its seventy years of life. The book charts how this institution has been ignored, worshipped, challenged, and seen as under threat throughout its history. It analyses changing cultural representations and patterns of public behaviour that have emerged, and the politics and everyday life of health. By looking at the NHS through the lenses of labour, activism, consumerism, space, and representation, this collection showcases the depth and potential of cultural history. This approach can explain how and why the NHS has become the defining institution of contemporary Britain.
countries (HealthConsumer Powerhouse, 2019 ). For example, the UK scores well on patient rights and information but poorly on accessibility (waiting times for treatment) and “amber” on outcomes. The Netherlands, on the other hand, score even better on patient rights and information than the UK, and also well on accessibility and outcomes (HealthConsumer Powerhouse, 2019 ).
The Picker Institute notes how Bismarck countries have embedded patient rights in statute. Germany issued a Charter of Rights for People in Need of Long-Term Care and Assistance
Public knowledge and activism in the UK’s national health services
richness of qualitative data and
sociological analysis can provide a valuable complement to these questions of meaning and
belief, enhancing and challenging the cultural histories that this collection addresses.
Lorelei Jones, ‘What Does a Hospital
Mean?’, Journal of Health Services Research & Policy , vol. 20, no. 4
(2015), pp. 254–6 .
Alex Mold, Making the Patient-Consumer: Patient
Organisations and HealthConsumerism in Britain
were sometimes at odds with the original aims of the campaign. But framing
health behaviours as the ‘choices’ of ‘consumers’ also
underplayed the impact of the environment and social structure on health, suggesting that
consumers had both too much agency and not enough. The chapter concludes by returning to
this issue as a way to think about the cultural and social history of the NHS.
Healthconsumerism, the NHS, and public health,
The idea that patients could be understood as
immunisation 1991–2001’, Vaccine , 23:48–49 (2005), 5670–87.
12 Jane Lewis, ‘The prevention of diphtheria in Canada and Britain 1914–1945’, Journal of Social History , 20:1 (1986), 163–76; Linda Bryder, ‘ “We shall not find salvation in inoculation”: BCG vaccination in Scandinavia, Britain and the USA, 1921–1960’, Social Science & Medicine , 49:9 (1999), 1157–67.
13 Alex Mold, Making the Patient-Consumer: Patient Organisations and HealthConsumerism in Britain (Manchester: Manchester University Press, 2015
financial incentive to do so. The single vaccine, given in two doses, was also much more convenient. However, this system still required parents to choose to vaccinate. This caused problems during the MMR crisis itself. For while there was little counter information or other options available to parents, there was only one obvious choice. When the MMR–autism link became more widely talked about and an alternative action was considered possible – separate vaccinations – choice became a major issue. The rise of the rhetoric around choice and growing healthconsumerism meant
population of ‘healthconsumers’ or students training
to be physicians. Storck’s efforts to promote these films
were not exclusively grounded in the wish to better citizens’
health, but were also a strategical attempt to better his standing
with national authorities and to secure his future career as a
filmmaker. The transformation of the film medium into a channel of
Rivett, From Cradle to Grave , p.
Alex Mold, Making the Patient-Consumer: Patient
Organisations and HealthConsumerism in Britain (Manchester: Manchester University
Press, 2015) , p. 98.
Report of the Committee on General Practice within the National
Health Service (London: HMSO, 1954), p. 23. On regulations see Paul
Addison, No Turning Back: The Peacetime Revolutions of Post-War Britain (Oxford:
, vol. 28, no. 2 (2017), pp. 268–304; Alex Mold,
Making the Patient-Consumer: Patient Organisations and HealthConsumerism in
Britain (Manchester: Manchester University Press, 2015) .
Sherryl Wilson, ‘Dramatising Health Care in
the Age of Thatcher’, Critical Studies in Television , vol. 7, no. 1 (2012),
pp. 13–18 .
Jennifer Crane, ‘“Save our
NHS”: Activism, Information-Based Expertise and the “New Times” of
Visualising obesity as a public health concern in 1970s and 1980s
people to interiorise health advice and show self-restraint,
while at the same time consuming more (albeit different) products to secure the continued success of the consumer society. Healthconsumerism demonstrated respect for the development of new diet markets and consequently the marketisation of nutrition and health itself.
In this process images were key. They repeatedly constructed and coded notions of acceptable health behaviour within established modes of