"Participative Democracy"

An article in the Guardian interviews Rupert Whitaker, a clinical academic who set up the Terrence Higgins Trust. His extensive experience on both sides of the healthcare system has given him a unique view of it! I particularly love his phrase 'participative democracy', which for me sums up the ideal patient-doctor relationship!

"Medical services," he says, "can never really be health-effective unless you have socialised medicine. But the system has to be a real participative democracy, so it's about the services patients actually need, not those that doctors think they do. The focus has to be: what does this person need to get well, and to stay well."

"We have to see patients as people, not collections of diseases."

"Everyone's exceptional in their own way. Some of my patients, I see them struggling . . . I feel grateful actually, for me: it could have been worse. But I've always been a pragmatic pessimist: I've seen what could go wrong, and I've fought as hard as I can to make sure that it doesn't. And I'm a real fighter."
But a lifetime's work on HIV and Aids (still, despite the success of combination therapies, "a very dangerous infectious disease, the more so because of the degree of complacency that has now crept in around it – people just think, I'll be fine"), a struggle without which "frankly, I'd probably be dead", has, he says, led him to this: the larger issue that HIV represents, "the burden of chronic illness, and how we address it. It's a complex area, how we get and stay well: it's biological, psychological, social, behavioural. But I'm a fighter. The penny will drop eventually."