Medicalisation in the UK: changing dynamics, but still ongoing

The UK is becoming a thoroughly medicalised nation, with various players: patients, doctors, other professionals, government and public health, acting in some cases to increase or in others to decrease medicalisation. Over a single professional lifetime, general medical practice has reversed from being mainly reactive work with doctors responding to patients’ symptoms, to a pro-active mass assessment of risk with extensive issuing of treatments, increasingly for people without symptoms at all. Statins are the model, already prescribed for about seven million people, with current proposals from the National Institute for Health and Care Excellence that would more than double the number of people receiving them. There are also calls for mass medication to reduce cardiovascular deaths through a ‘polypill’, containing several drugs. The medical literature, mainly written by doctors, described numerous advantages of medical treatments, whereas historically, the social science literature, mainly written by social scientists, often described adverse effects and critiqued medicalisation. The previous gap between the literature of the medical and social sciences has closed and instead there are changing dynamics in medicalisation which create conflicts between different players.