Managing diabetes, managing medicine: chronic disease and clinical bureaucracy in post-war Britain

List of figures -- Acknowledgements -- List of abbreviations -- Introduction: Managing diabetes, managing medicine -- 1. Chronicity and the care team in Britain's New Jerusalem -- 2 Diabetes, risk management, and the birth of modern primary care -- 3. The making of integrated care -- 4. Retinopathy screening and the new politics of prevention -- 5. Constructing standards at a time of crisis -- 6. Making managerial policy in the neoliberal moment -- Epilogue -- Bibliography -- Index.

This electronic version has been made available under a Creative Commons (BY) open access license. This book is available as an open access ebook under a CC-BY-NC-ND licence.Through its study of diabetes care in twentieth-century Britain, Managing diabetes, managing medicine offers the first historical monograph to explore how the decision-making and labour of medical professionals became subject to bureaucratic regulation and managerial oversight. Where much existing literature has cast health care management as either a political imposition or an assertion of medical control, this work positions managerial medicine as a co-constructed venture. Although driven by different motives, doctors, nurses, professional bodies, government agencies and international organisations were all integral to the creation of managerial systems, working within a context of considerable professional, political, technological, economic and cultural change

Through a study of diabetes care in post-war Britain, this book is the first historical monograph to explore the emergence of managed medicine within the National Health Service. Much of the extant literature has cast the development of systems for structuring and reviewing clinical care as either a political imposition in pursuit of cost control or a professional reaction to state pressure. By contrast, Managing Diabetes, Managing Medicine argues that managerial medicine was a co-constructed venture between profession and state. Despite possessing diverse motives – and though clearly influenced by post-war Britain's rapid political, technological, economic, and cultural changes – general practitioners (GPs), hospital specialists, national professional and patient bodies, a range of British government agencies, and influential international organisations were all integral to the creation of managerial systems in Britain. By focusing on changes within the management of a single disease at the forefront of broader developments, this book ties together innovations across varied sites at different scales of change, from the very local programmes of single towns to the debates of specialists and professional leaders in international fora. Drawing on a broad range of archival materials, published journals, and medical textbooks, as well as newspapers and oral histories, Managing Diabetes, Managing Medicine not only develops fresh insights into the history of managed healthcare, but also contributes to histories of the NHS, medical professionalism, and post-war government more broadly.