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Modernisation of Roles

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

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TENDING THE ‘SICK’

RESPONSIBILITY CHOICE EXPERT PATIENT

MANAGERS EDUCATORS / ADVOCATES

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The Role of the Patient

The Role of the NurseSPECIALISTS

1942 The

Beveridge Report

DH 1997The New

NHS

DH 2001The Expert

Patient

DH 2004Choosing

Health

DH 2005Independence,

Wellbeing & Choice

DH 2010Equity &

Excellence

DH 2010Healthy Lives,

Healthy People

DH 2006Our Health, Our Care, Our Say

DH 2006Modernising Nursing

Careers: Setting the Direction

1946 The NHS Act

DH 2000The NHS

Plan

DH 1999Saving Lives:

Our Healthier Nation

DH 2005Self-care: A Real Choice

DH 2001Tackling Health

Inequalities

REFERENCES

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