Re-Imagining The UK National Health Service Patient In a Neo-Liberal Policy Context

Historically, the UK National Health Service (NHS) has been taxpayer funded, and largely free to patients. Though some private sector service has always been part of the NHS, this has increased substantially in the last 15 years. Hospitals are important sites for biomedical research, with many patients participating in studies, though this is voluntary. While much research is state-funded, there is also privately funded research in NHS hospitals. In policy terms, the NHS is now being seen as a potential driver for economic growth, as a well as a service to citizens.

In this paper, I will analyse an initiative that represents a new configuration between public and private, and a re-imagining of the patient’s role in the UK NHS. This is an NHS Biobank. A biobank is a repository of biological specimens combined with data about the donors of those specimens, stored for the purposes of medical research. In this instance, the aim is that samples will be collected routinely from NHS hospital patients (with consent), but, rather than patients consenting for a specific study, they will give an enduring and general consent for their samples to be used. At the same time, their samples will be linked to the data that is collected about them for clinical (rather than research) purposes. Biomedical researchers are excited about the possibilities that such a biobank may offer, and there is a significant private sector involvement in the funding of this initiative, though it remains part of the NHS.

I will argue that this initiative represents a re-ordering of the moral contract between the UK NHS and its patients. Rather than receiving NHS services as a right of citizens and taxpayers, there is now an increased expectation that NHS patients will donate samples and data to be used in (commercial) biomedical research.