Introducing the publication by R. Flores: The changing place of care and compassion within the English NHS: an Eliasean perspective

In the wake of the Francis Report, a public conversation has arisen in England about the place of compassion within healthcare settings, particularly regarding the causes of failures in the provision of adequate healthcare, and the desirability and possibility of fostering compassion in the NHS. A contribution to this conversation, this article takes as a starting point an oft-overlooked socio-historical phenomenon: social expectations of compassion in healthcare practice have shifted in comparison to what was the case at the NHS’s inception in 1948, so that both healthcare professionals and the public have come to perceive and expect compassion as an intrinsic component of healthcare. We argue that this expectation can be partly explained drawing on Elias’s concept of ‘functional democratisation’: as power asymmetries between different social groups (e.g. doctors and patients) have declined in recent decades, so have norms and expectations of compassionate care increased. Failures to provide compassionate care in some specific settings can also be partly understood as an outcome of a wider erosion of functional democratisation resulting from the growth in social inequality witnessed in England and much of the world since the 1970s. We thus call for addressing failures of care within healthcare settings through broader social policies.

The text of the article can be found here.