Medical autonomy and the UK state 1975 to 2025

Medical autonomy in the United Kingdom has declined over the last twenty-fi ve years, whether considered at the micro level (such as control over treat ment and,work patterns),the meso level (in terms of corporatist relations w ith the state) or the macro level (in terms of the 'biomedical model'). Aft er a period in the early 1990s when the National Health Service displayed a mix of Fordist and post-Fordist controls. the emphasis has swung sharply t owards the former, suggesting the continued explanatory value of theories w hich focus on the state's need both to contain welfare expenditure and to m aximise the political legitimacy derived from it. The analysis of this rela tively narrow area of sociology has implications for the study of much broa der questions about the capacity and legitimacy of the state in the twenty- first century.