The NHS as an unsustainable legacy cost? Patient rights and the duties of doctors and the state, 1720s to 2000s

Professor Steven King

(University of Leicester)

9th November 2011

At a time when the Government is seeking to redefine the role of doctors in health care commissioning, subsidiary budget holders faced by the prospect of financial meltdown are seeking to pare back treatments regarded as ‘rights’ by some sections of the British population. Meanwhile public health initiatives long regarded as ‘obligations’ on the part of locality and state are being undermined. We can therefore see that the question of rights and duties remains a thorny issue at the heart of our health care system. This lecture will take a long term view of the evolution of notions of the rights of the patients and the duties of doctors and the state. Ranging between the 1720s (when arguably the rights of patients and the duties of doctors first became an issue as doctoring moved down the social scale) to the 2000s (when financial constraints mean that we might have to redefine the very concepts of right and duty) the lecture will embody two central arguments: Firstly that modern popular understandings of rights and duties are deeply embedded from the earliest trickling down the social scale of health care options; Second, that the 200+ year mould of patient rights and analogous duties for the state and medical professionals will inevitably be broken as our healthcare system comes to look increasingly like a ‘legacy cost’ in an evolving shift of global economic power.

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