9780335203673

Patient Power? : The Politics of Patients' Associations in Britain and America

by
  • ISBN13:

    9780335203673

  • ISBN10:

    0335203671

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2000-05-01
  • Publisher: Open University Press
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Summary

There is a rapidly growing number of patients' associations relating to a specific medical condition or illness (such as multiple sclerosis or motor neurone disease) but they have received little academic attention. Bruce Wood has surveyed over 200 of these associations in each of the USA and the UK. They have been marginalized in accounts of health policy and services and yet collectively they are 'big business'. They perceive themselves as being non-political support groups but they actually participate in much activity that is political. Patient Power? asks: * are these economically efficient and politically effective bodies? * is the US 'business' or the UK 'volunteer' model more successful? * are they truly independent organizations or have they been 'colonized' by the big vested interests in health? * are they a signal of a more assertive patient or consumer? * do they actually influence what health care people receive? This is a ground-breaking study in health policy and management, and will be important reading for scholars, students and professionals and, in particular, for those involved in running patient organizations.

Author Biography

Bruce Wood has been in the Department of Government at Manchester University since 1968, and is currently Dean of the Faculty of Economic and Social Studies. His previous books have been on the 1974 reforms of local government, on public policy-working in Britain, and on the regulation of doctors in the UK, USA and Germany. He chaired a health authority from 1989-1996 and serves on the board of his local hospice.

Table of Contents

Series editor's introduction xi
Preface xiii
Part I: Methodology and findings 1(32)
Why study patients' association politics?
3(16)
Why this study?
3(1)
The literature on patients' associations
4(5)
The choice of groups and localities
9(1)
Why compare cross-nationally?
10(1)
Political implications of the growth of associations
11(1)
How effective are patients' associations?
12(5)
Conclusions
17(2)
Approach, methods and sources
19(14)
Comparative evidence: problems and opportunities
19(2)
Definitions: which associations to include?
21(3)
Key sources: national and local
24(4)
The framework of influence: political resources
28(4)
Conclusions
32(1)
Part II: The national level 33(82)
Exploding numbers
35(16)
Rapid growth
35(5)
One illness, one association?
40(3)
Chronic and acute diseases
43(3)
Business and social characteristics
46(4)
Conclusions
50(1)
Activities and finances
51(18)
Membership levels
51(5)
Aims and activities
56(4)
Staffing
60(2)
Finances
62(6)
Conclusions
68(1)
The political economy of patients' associations: efficiency and effectiveness
69(23)
Probity: financial irregularities
70(2)
Financial efficiency: high-cost charities
72(6)
In whose interests? Autonomy and professional colonization
78(8)
Excessive autonomy: turfism?
86(4)
Conclusions
90(2)
The political effectiveness of patients' associations
92(23)
Political resources
93(4)
Influencing individual professionals: the micro level
97(3)
Influencing institutions: the intermediate level
100(5)
Macropolitics: political campaigning at the national level
105(4)
Collaborative politics
109(4)
Conclusions
113(2)
Part III: Comparing conurbations 115(54)
The organizational context
117(13)
Two conurbations: the basis of comparison
117(2)
Branches and chapters: parallel underactivity
119(4)
Salaries and volunteerism: contrasting worlds
123(2)
Boards and committees: strengths and weaknesses
125(3)
Conclusions
128(2)
St Louis -- local strength?
130(19)
Structure and autonomy
131(3)
Chapter size
134(2)
Services and activities
136(5)
Liaison and collaboration
141(5)
Conclusions
146(3)
Greater Manchester -- local weakness?
149(20)
Structure and autonomy
151(3)
Branch size
154(4)
Services and activities
158(4)
Liaison and collaboration
162(2)
The St Louis all-volunteer chapters
164(1)
Conclusions
165(4)
Part IV: Conclusions 169(23)
Conclusions -- patients' associations, politics, states and democracy
171(21)
Now you see them, now you don't
171(1)
Associations as emerging `challengers'?
172(4)
Institutional issues
176(3)
Patients' associations and the state
179(3)
Associations as contributors to the democratic policy?
182(5)
Designing `effectiveness indicators'
187(5)
References 192(3)
Index of associations 195(5)
Subject index 200

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