ABSTRACT
The power brokers referred to in the previous chapter operate within a complicated and dynamic context. Health services are, at one and the same time, hugely important social utilities and big business. Throughout the developed economies they account for around 10% of GDP, in the USA it is 18% (McKinsey & Co 2019). They provide employment for huge numbers of people; in the UK the national health component alone employs around 1.3 million people. Their work affects virtually all citizens and is capable of stirring considerable emotion. It is hardly surprising that decisions about the current and future direction of the services involved attract attention and that the various stakeholders seek to mobilize themselves in order to influence events.
