ABSTRACT
At the heart of what the author hopes, we can build are good relationships. Of course, in relationships with medical professionals, patients should be participants and partners. But ultimately they must be the decision makers in medical and social consultations about their lives. The key point about partnership is not only to recognize that the patient-doctor partnership is pivotal, but that no partnership is real unless the individual has the power to secede from it to another. Both individuals and institutions need to have adequate autonomy. Institutions and their management must have an unrelenting and inevitable responsiveness to consumers' wishes, and the capacity to utilize appropriate freedoms. The Patient-Guaranteed Care Association (PGCA) as the purchasing co-operative would intrude more urgency, more money and more insistence to improve services, change attitudes, enhance counselling and also require by contract that appropriate staff structures were in place. The PGCA would be able to attain these objectives. Greater efficiency would increase resources.
