Modernisation of Roles

1. Modernisation of Roles The Role of the Patient Following the second world war Parsons (1975) presented the idea of the ‘sick role’ in which the patient is seen as a social deviant and there is a hierarchical inequality between the patient and therapeutic agencies e.g. doctors and nurses. Parson’s theory suggested that patients only had choice in as much as they could choose to accept the fact that they were ill and seek professional help to get better. However, once they had sought the help they needed, the physician took over fiduciary responsibility for their illness. This limitation of patient choice is also demonstrated by the fact that during this period patients could no longer self-refer to hospital as they had done in the past. Instead they had to be referred by a GP. This can be viewed as institutionalisation of the separation of primary and secondary care. It achieved what the government wanted, and what GPs and consultants wanted – efficient and cost effective care/treatment. However, it limited patient choice in where they received their treatment and by whom. If Parson’s theory of the sick role was correct, then the nurse-patient relationship was not an equal one at this time. Instead, the nurse was the figure of authority, and the patient was expected to obediently entrust his care to her. SICK ROLE TENDING THE ‘SICK’ RESPONSIBILITY CHOICE EXPERT PATIENT MANAGERS EDUCATORS / ADVOCATES SA 211 DH 2001 The Expert Patient DH 1999 Saving Lives: Our Healthier Nation DH 2006 Our Health, Our Care, Our Say 1942 The Beveridge Report DH 2005 Independence, Wellbeing & Choice DH 2010 Equity & Excellence DH 2000 The NHS Plan DH 2001 Tackling Health Inequalities DH 2006 Modernising Nursing Careers: Setting the Direction DH 2004 Choosing Health DH 2005 Self-care: A Real Choice DH 2010 Healthy Lives, Healthy People 1946 The NHS Act DH 1997 The New NHS The Role of the Nurse SPECIALISTS REFERENCES