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Ideas are key components of health policy and health systems. They shape everything that happens and is done, including all healthcare practices. In this book I explore the ways in which key ideas about healthcare are changing, focusing in particular on the rise of a ‘social’, as loosely contrasted with a ‘clinical’, approach to healthcare. I argue that these changes – in which biomedical concerns are increasingly seen as nested within (often contentious) personal and social concerns – is part of a major historical transition. This transition is not just about the changing patterns of ill-health (with, for example, the growth in salience of long-term conditions) or even the broader social transitions manifested in trends such as the decline in deference or the rise in patient or public expectations, but is also a deeper philosophical transition in our conceptions of the nature and purpose of healthcare. While welcoming this transition I set out and explore the additional challenges that it produces for health policy, and argue that these challenges should push us towards building a ‘learning healthcare system’ in a very expansive sense.
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