ABSTRACT
This chapter considers health needs embodied in contested professional discourses. It focuses on the extent to which professional debates concerning needs can be explained in terms of strategic action or communicative action. The discussion is illustrated with transcribed extracts from the review group’s internal debates and minutes of meetings held with 12 renal units in London. The Royal Free was a unit where review group’s deliberations were seen much more as a threat to the unit’s future. The unit had emphasised the high quality of its service, its cost effectiveness relative to other London units and its accessibility to patients. The possibility of losing out to a judgement that gave too much weight to ‘academic’ status at the expense of the above qualities was therefore a considerable concern. The emphasis here was on the research and academic excellence of the hospital as a whole and for the renal unit.
