The business of the NHS: The rise and rise of consumer culture and commodification in the provision of healthcare services

Abstract

The implementation of market reforms has transformed the National Health Service (NHS) from a single national healthcare provider to a complex conglomeration of national and private organisations providing healthcare under the umbrella of the NHS brand. Private and state-run organisations compete to provide services to increasingly knowledgeable and entrepreneurial healthcare consumers. As a result, the NHS has become more and more business-like and is subject to the same consumer drivers that can be identified elsewhere in society. Healthcare consumers are not typical ‘customers’, however, since most consume NHS services out of necessity and the state funds the care they receive. Yet it is this ‘necessity’ of consumption that makes contracts to provide services on behalf of the NHS such a valuable commercial opportunity for private providers. This paper examines how consumer culture has influenced attitudes towards health and dying and is contributing to the creeping commodification of healthcare consumers themselves.