Book-ended by publication of the consultative paper, Patients first in 1979, and creation of the internal market in 1990, Thatcher's term as prime minister marked an era of ‘continuous revolution’ in health policy. The notion that patients could be regarded as consumers was not a new one in Margaret Thatcher's Britain, but it was between 19 that the patient-consumer moved from the shadows to centre-stage. This development thus raises questions not only about who speaks for the consumer, but also about the relationship between citizenship and consumption in contemporary Britain. By the end of the 1980s, however, the patient-consumer was reconfigured by the Conservative government, and emphasis moved from the collective needs of patient-consumers to the rights of individuals within increasingly marketized services.
Through their work in these areas, patient groups built up a kind of patient consumerism that was concerned with the needs of the wider population, as well as representing demands made by individual patient-consumers. By examining the activities of patient groups around three key themes – the provision of information, the development of patients' rights, and the notion of patient choice – this article shows that ideas about what it meant to be a patient-consumer came initially from patient groups. Though patients had been regarded as consumers prior to this period, it was during the 1980s that the patient-consumer moved from the margins to centre-stage.
It details a crucial moment in the reconstitution of the relationship between state and citizen, as universal entitlements to welfare gave way to individualistic rights to, and choice of, services.
This article examines the role played by patient organizations in the making of the patient as consumer during Margaret Thatcher's term as prime minster.
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