Patients and doctors: reformulating the UK health policy community?

The rise of the active health care consumer in the United Kingdom requires a reformulation not only of the traditional relationship between patients and doctors, but also of the macro-politics of health which reflect and service that relationship. Market and democratic themes have supplied an ideological impetus to the pressures for change. The well-publicised problems of medical self-regulation have given them practical political expression. However, the response from the policy community still reflects the dominant partners within it, medicine and the state. What neither partner has recognised is that the functionality of the policy community has been undermined by the different and issue-based challenges to the traditional patient–doctor relationship. As a result, the state is likely to remain the lead player in an increasingly unstable politics of health where consumerist issues are on the policy agenda, but patient groups are still excluded from the policy community.