Review

Private choices in public

GOING PRIVATE: WHY PEOPLE PAY FOR THEIR HEALTH CARE
Michael Calnan, Sarah Cant and Jonathan Gabe
Open University Press, 1993, £10.99

The proportion of the population covered by private medical insurance increased from five per cent in 1979 to a peak of around 13 per cent in 1989, falling to 11 per cent in 1992. About a quarter of those covered are individual subscribers, with a half in company schemes and a further fifth in group schemes.

But does the rapid expansion of the private medical market, maintained throughout the eighties, imply that fourteen years of government by the Right has eroded popular belief in collective provision of health care?

Not according to the findings of the fascinating study reported in this slim volume. The authors surveyed over 3,000 men (the title of the book overstates a little) in Kent on their use of private medicine, and followed this up with in-depth interviews with sixty.

Far from finding a consensus around right-wing values among those with private insurance, whether company or individual, there was a strong agreement that the NHS was, in general the ‘ideal’. But people used private health care for pragmatic reasons — especially to avoid long waits — often explicitly recognising the contradiction between their beliefs and practice.

Perhaps NHS policymakers should read Going private and take note: not many people want to be ‘customers’.