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The political economy of health careWhere the NHS came from and where it could lead$
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Julian Tudor Hart

Print publication date: 2010

Print ISBN-13: 9781847427830

Published to Policy Press Scholarship Online: March 2012

DOI: 10.1332/policypress/9781847427830.001.0001

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How does it produce?

How does it produce?

(p.35) Three How does it produce?
The political economy of health care

Julian Tudor Hart

Policy Press

The NHS care system operates in ways entirely different from commodity-producing industries. Progress in health care depends on developing professionals as sceptical co-producers of health gains rather than salesmen of process, and developing patients as sceptical co-producers rather than consumers searching for bargains and shorter queues. When applied to health care systems, management policies derived from industrial commodity production, and incentive systems of reward and punishment based on that model, are demoralising to staff and patients. Health care requires an entirely different body of economic theory, only the outlines of which are beginning to become clear, to which health economists have as yet contributed little. Beginnings of these already exist in the NHS, but will develop optimally only within a gift economy and culture, separated entirely from the economy and culture of commerce.

Keywords:   NHS, health care, health gain, industrial commodity production, health economists, gift economy

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