Julian Tudor Hart - Author

Author

He is the author of many books and scientific articles. His most recent book, The Political Economy of Health Care: A Clinical Perspective explores how the NHS might be reconstituted as a humane service for all (rather than a profitable one for the few) and a civilising influence on society as a whole. The book provides 'a big picture' for students, academics, health professionals and NHS users that Tudor Hart hopes will inspire them to challenge received wisdoms about how the NHS should develop in the 21st century.

Hart lists nine (9) characteristics of the National Health Service in its founding that are distinctive and essential to it.

1. A united national service devoted directly and indirectly to care, fully available to all citizens.
2. A gift economy including everyone, funded by general taxation, of which the largest component was income tax.
3. Its most important inputs and processes are personal interactions between lay and professional people.
4. Its products were potentially measurable as health gains for the whole population.
5. Its staff and component units were not expected to compete for market share but to cooperate to maximize useful service.
6. Continuity was central to its efficiency and effectiveness.
7. Its local staff and local populations believed they had moral ownership of and loyalty to neighborhood NHS units.
8. None of its decisions and few of its procedures could be fully standardized. All of its decisions entailed some uncertainty and doubt. They were therefore unsuited to commodity form, either for personal sale or for long-term contracts.
9. The NHS was a labour-intensive economy. Every new diagnostic or therapeutic machine generates new needs for more skilled staff able to control and interpret the work of the machines and translate them into human terms.

His other writing includes many articles on the management of high blood pressure and on the organisation of health services. His most influential, The Inverse Care Law, published in the Lancet 1971 asserts: "The availability of good medical care tends to vary inversely with the need for the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced."