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Most people plan to have a quiet time in their eighth decade, but Julian Tudor Hart has completed his with a flourish, not only winning the College's prestigious Discovery Prize, but also publishing his latest book — The Political Economy of Health: A Clinical Perspective.1
The book is a blast (worth reading for the footnotes alone) and, as usual, the author has his finger on the pulse of what is happening in the NHS. For those who have forgotten, there is a lot on the origins of the NHS and how it has developed so far. But the most important part of the book concerns the future. A major part of the story is Julian's, having pioneered the population approach to clinical care that is now orthodox and, in doing so at Glyncorrwg Health Centre in South Wales, contradicting his inverse care law.
This work required an epidemiological approach, but it was rooted in the clinical care and long-term relationships that are at the heart of general practice, and are the basis of the public's frequently and consistently expressed trust in family doctors. The contribution of primary care to health improvement needs both elements. Julian argues that this is not a provider/consumer relationship, but a collaborative one, producing social value, which economists and NHS policy advisers seem unable to understand. For many people, the NHS provides expression for the type of society in which they prefer to live and work. Ironically, 35 years after his Lancet essay on the inverse care law,2 highlighting the threat of market forces to this ideal, these forces are again gathering strength.
To mark Julian Tudor Hart's 80th birthday, a special meeting is being held in Glasgow on Saturday 3 March, ‘Looking forwards, not backwards, at the NHS’, with contributions from Allyson Pollock, George Davey Smith, Phil Hanlon, Graham Watt and Julian Tudor Hart. Everyone who wishes to come is warmly invited. For details see: http://www.gla.ac.uk/departments/generalpractice/events-tudorhart.htm