This chapter examines the double-bed relationship between the state and the medical profession in Great Britain, one of the key organisational features of the NHS. It explains that under this relationship there was a dynamic of national accountability and local paternalism. It discusses the changes in the politics of the double-bed since 1948 and suggests that the wider participation of the private sector in the NHS has made the relationship between the state and the medical profession more contingent than before.
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