What is the Role of the Consumer in Health Care?

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Abstract
Recent government policy in the UK National Health Service (NHS) has carried with it an implicit assumption that greater consumer involvement in health care is both desirable and beneficial. This may be the case in theory, but in practice there are substantial barriers to consumers becoming more involved in health care. Following a consideration of the role the government envisages for consumers in the NHS, the extent to which it is possible for consumers to fulfil this role, and more fundamentally whether they want to fulfil it, are discussed. It is argued that because of the extent of the breakdown of consumer sovereignty in health care, the doctor–patient (agency) relationship assumes a particularly important role. The theory of agency and its application to health care is then discussed and a number of important issues highlighted. A review of the literature on the extent of consumer involvement in health care precedes the conclusion in which the key issues raised in the article are brought together.