MAKING THE PATIENT-CONSUMER IN MARGARET THATCHER'S BRITAIN

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. 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. 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. 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. 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 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. 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.