ABSTRACT
As Adam Smith famously said in The Wealth of Nations, professionals do not necessarily meet together only for ‘merriment and diversion’, but often in conspiracy in pursuit of their own interests. Professionals are often accused of regarding themselves with marked self-satisfaction. Certainly, experience suggests that they will not normally vote for change if this threatens something of substance which they hold to be valuable. They have often been an intransigent, high-status minority living in a protected environment (‘The Secret Garden’) within the wider structure. Yet Mr. David Cameron has proposed giving power back to the front-line, to doctors. On the demand side, what Mr. Cameron has proposed is to revive the GP Fundholder or ‘quasi-market’ of the Thatcher years. This initiative in the 1990s was positive, although it was widely resisted within the service on the basis of ‘equity’.
