ABSTRACT
The title of this chapter reflects the emergence, through the introduction of the General Practitioner (GP) contract in 1990, of an approach to health promotion which encouraged United Kingdom health promotion services and activities to be seen as health commodities by the users, providers and purchasers of these services. Through these developments good health began to be approached as an ‘elective’ state, which could be achieved and enhanced by a range of consumer activities which directed the individual towards being more healthy. Such an approach encouraged users and providers to adopt a ‘pick and mix’ approach and is consistent with a rhetoric of consumer empowerment and involvement-principles of the ‘new public health’ that were laid out in the Alma Ata Declaration (WHO, 1978). It is also consistent with the philosophy of the NHS reforms which included the New GP Contract, in appearing to encourage a greater range of choices for individuals in their health care, and a greater level of individual responsibility for health status.
