Abstract

This book is a critical ethnography of decision making with respect to the assessment of health care need in the UK health system. Theories of need, justice and rights are reviewed in relation to the structural changes the National Health Service experienced in the early 1990s. To illustrate the arguments, a case study of planning services for kidney failure patients in London is used. The decisions of a group of professionals involved in an independent review of government services are evaluated critically using particular theories of need and communicative action. The relationship between needs, as understood and defined by medical and managerial groups and markets forms the focus for a more general critique of the reformed UK health system.