I’ve been recommending this new, significantly revised edition ever since Julian sent me a copy last year. He is able to explain better than any living doctor or politician, how vital politics are to health care, even down to the intimate relationships between doctors and patients. Most GPs are exhausted with the effort of dealing with our patients and the management of our practices. We lack the time and knowledge to understand our work in its political and historical contexts. We need to read this book.
This book however is written not for doctors, but for patients. Patients have always been the greatest supporters of the NHS whilst doctors, concerned about their own class based interests have at times been its bitterest opponents. Now we face what may be the end of the NHS . The Coalition’s Health White Paper far from being a radical document, is a predictable stage in a 20 year process of converting the gift economy of the NHS into a market economy.
Just as the NHS depended on the will of the people for it to be created, its future depends on us all. This book is a history of the struggle and a call to arms.
The second edition of Julian Tudor Hart’s Political Economy of Health Care
is published on September 1st 2010.
Sir Ian Gilmore, President of the Royal College of Physicians of London,
“This is a remarkable book by a remarkable man. Anyone who professes to
believe in patient-centred care (including our most recent two
governments) need to read it to understand that to be patient-focused you
must also be public- and population-focused, challenging markets and
Graham Watt, Professor of General Practice at Glasgow University Medical
“Julian Tudor Hart’s example was not only to imagine but also to deliver
integrated care for all his patients over 25 years, using epidemiology
to measure what he did and to show what could be achieved. For health
care systems round the world, facing problems of fragmentation,
spiralling costs and increasing inequity, the gauntlet he threw down is
to develop similarly integrated systems for the societies they serve.”
John Frey, Professor of Family Medicine at the University of Wisconsin
School of Medicine and Public Health, writes:
“Rather than writing from an abstract view of general practice, Hart
brings a life time of experience among his patients to bear on the history
and changes in the NHS. He raise cautions as well as provides a vision
for the future. In the end, he sees general practice in the context of
community as a testing ground for ideas that should reshape the NHS. Hart
has been recognized around the world as one of the great scientists of
community health. His ideas are born from his work in practice in the
deprived where he practiced combined with his broad knowledge of the
mistakes and confused policies of the past that have delayed getting
proven care to the those who are most at risk in any community. This book
brings Hart’s distinctive, passionate voice to bear on his personal
journey through his 60 years of the NHS and carries his tempered optimism
that we can all do better.”