Julian Tudor Hart
Encyclopedia
Julian Tudor Hart is a British physician
.
.
He worked for 30 years as a general practitioner in Glyncorrwg
, West Glamorgan
, Wales
, where his partner was Dr Brian Gibbons
, later minister for health in Wales. He is a passionate advocate of the National Health Service
and of socialism
. He is an active member of the Socialist Health Association
.
In 2006 he was awarded the inaugural Discovery Prize by the Royal College of General Practitioners
as " a general practitioner who has captured the imagination of generations of GPs with his groundbreaking research... His practice in Glyncorrwg
, Wales, was the first in the UK to be recognised as a research practice, piloting many Medical Research Council studies. He was also the first doctor to routinely measure every patient’s blood pressure and as a result was able to reduce premature mortality in high risk patients at his practice by 30%. Graham Watt, Professor of General Practice at the University of Glasgow, nominated Dr Tudor Hart for the award. Professor Watt said: “His ideas and example pervade modern general practice and remain at the cutting edge of thinking and practice concerning health improvement in primary care. His work on hypertension showed how high quality records, teamwork and audit are the keys to health improvement. His life-long commitment to the daily tasks of general practice has always given his work and views a salience and credibility with fellow general practitioners. Julian Tudor Hart has been and will remain an inspiration to health practitioners and the communities they serve.”
Hart lists nine (9) characteristics of the National Health Service
in its founding that are distinctive and essential to it.
His other writing includes many articles on the management of high blood pressure and on the organisation of health services. His most influential, The Inverse Care Law, published in the Lancet 1971 asserts: "The availability of good medical care tends to vary inversely with the need for the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced."
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
.
Biography
He studied medicine at Cambridge University and in LondonLondon
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
.
He worked for 30 years as a general practitioner in Glyncorrwg
Glyncorrwg
Glyncorrwg is a village in Britain. It is set in the Afan Valley, in south Wales.Glyncorrwg is also the name of an electoral ward and a community covering the village and surrounding countryside, in Neath Port Talbot county borough.- History :...
, West Glamorgan
West Glamorgan
West Glamorgan is a preserved county and former administrative county of Wales, one of the divisions of the ancient county of Glamorgan.West Glamorgan was created on 1 April 1974, by the Local Government Act 1972 from the county borough of Swansea, the municipal boroughs of Neath and Port Talbot,...
, Wales
Wales
Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
, where his partner was Dr Brian Gibbons
Brian Gibbons
Dr Brian Gibbons, AM, FRCGP was the Labour Party Assembly Member for Aberavon from May 1999 to May 2010, when he stood down...
, later minister for health in Wales. He is a passionate advocate of the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
and of socialism
Socialism
Socialism is an economic system characterized by social ownership of the means of production and cooperative management of the economy; or a political philosophy advocating such a system. "Social ownership" may refer to any one of, or a combination of, the following: cooperative enterprises,...
. He is an active member of the Socialist Health Association
Socialist Health Association
The Socialist Medical Association was founded in 1930, in order to campaign for a National Health Service in the United Kingdom. It took in many of those who had been active in the State Medical Service Association...
.
In 2006 he was awarded the inaugural Discovery Prize by the Royal College of General Practitioners
Royal College of General Practitioners
The Royal College of General Practitioners is the professional body for general practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with...
as " a general practitioner who has captured the imagination of generations of GPs with his groundbreaking research... His practice in Glyncorrwg
Glyncorrwg
Glyncorrwg is a village in Britain. It is set in the Afan Valley, in south Wales.Glyncorrwg is also the name of an electoral ward and a community covering the village and surrounding countryside, in Neath Port Talbot county borough.- History :...
, Wales, was the first in the UK to be recognised as a research practice, piloting many Medical Research Council studies. He was also the first doctor to routinely measure every patient’s blood pressure and as a result was able to reduce premature mortality in high risk patients at his practice by 30%. Graham Watt, Professor of General Practice at the University of Glasgow, nominated Dr Tudor Hart for the award. Professor Watt said: “His ideas and example pervade modern general practice and remain at the cutting edge of thinking and practice concerning health improvement in primary care. His work on hypertension showed how high quality records, teamwork and audit are the keys to health improvement. His life-long commitment to the daily tasks of general practice has always given his work and views a salience and credibility with fellow general practitioners. Julian Tudor Hart has been and will remain an inspiration to health practitioners and the communities they serve.”
Author
He is the author of many books and scientific articles. His most recent book, The Political Economy of Health Care: A Clinical Perspective explores how the NHS might be reconstituted as a humane service for all (rather than a profitable one for the few) and a civilising influence on society as a whole. The book provides 'a big picture' for students, academics, health professionals and NHS users that Tudor Hart hopes will inspire them to challenge received wisdoms about how the NHS should develop in the 21st century.Hart lists nine (9) characteristics of the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
in its founding that are distinctive and essential to it.
- A united national service devoted directly and indirectly to care, fully available to all citizens.
- A gift economyGift economyIn the social sciences, a gift economy is a society where valuable goods and services are regularly given without any explicit agreement for immediate or future rewards . Ideally, simultaneous or recurring giving serves to circulate and redistribute valuables within the community...
including everyone, funded by general taxation, of which the largest component was income tax. - Its most important inputs and processes are personal interactions between lay and professional people.
- Its products were potentially measurable as health gains for the whole population.
- Its staff and component units were not expected to compete for market share but to cooperate to maximize useful service.
- Continuity was central to its efficiency and effectiveness.
- Its local staff and local populations believed they had moral ownership of and loyalty to neighborhood NHS units.
- None of its decisions and few of its procedures could be fully standardized. All of its decisions entailed some uncertainty and doubt. They were therefore unsuited to commodity form, either for personal sale or for long-term contracts.
- The NHS was a labour-intensive economy. Every new diagnostic or therapeutic machine generates new needs for more skilled staff able to control and interpret the work of the machines and translate them into human terms.
His other writing includes many articles on the management of high blood pressure and on the organisation of health services. His most influential, The Inverse Care Law, published in the Lancet 1971 asserts: "The availability of good medical care tends to vary inversely with the need for the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced."
Scientific articles
- Hart JT. Semi-continuous screening of a whole community for hypertension. Lancet. 1970; ii:223-6.
- Hart JT. The Inverse Care Law. Lancet. 1971; i:405-12.
- Hart JT. Milroy Lecture: the marriage of primary care and epidemiology: continuous anticipatory care of whole populations in a state medical service. Journal of the Royal College of Physicians of London. 1974; 8:299-314.
- Hart JT. Management of high blood pressure in general practice. Butterworth Gold Medal essay. Journal of the Royal College of General Practitioners. 1975; 25:160-92.
- The Black ReportBlack ReportThe Black report was a 1980 document published by the Department of Health and Social Security in the United Kingdom, which was the report of the expert committee into health inequality chaired by Sir Douglas Black...
: a challenge to politicians. Lancet 1982;i:35-7. - Hart JT. Measurement of omission. British Medical Journal. 1982; 284:1686-9.
- Watt GCM, Foy CJW, Hart JT. Comparison of blood pressure, sodium intake, and other variables in offspring with and without a family history of high blood pressure. Lancet. 1983; i:1245-8.
- Watt GCM, Foy CJW, Hart JT, Bingham G, Edwards C, Hart M, Thomas E, Walton P. Dietary sodium and arterial blood pressure: evidence against genetic susceptibility. British Medical Journal. 1985; 291:1525-8.
- Hart JT. Practice nurses: an underused resource. British Medical Journal. 1985; 290:1162-3.
- Hart JT, Humphreys C. Be your own coroner: an audit of 500 consecutive deaths in a general practice. British Medical Journal. 1987; 294:871-4.
- Hart JT. Primary medical care in Spain. British Journal of General Practice. 1990; 40: 255-8.
- Hart JT, Thomas C, Gibbons B, Edwards C, Hart M, Jones J, Jones M, Walton P. Twenty-give years f audited screening in a socially deprived community. British Medical Journal. 1991; 302:1509-13.
- Hart JT. Two paths for medical practice. The Lancet. 1992 sept 26; 340
- Hart JT. Rule of halves: implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care. British Journal of General Practice. 1992; 42:116-9
- Hart JT, Edwards C, Haines AP, Hart M, Jones J, Jones M, Watt GCM. High blood pressure screen-detected under 40: a general practice population followed for 21 years. British Medical Journal. 1993; 306:437-40.
- Hart JT. Clinical and economic consequences of patients as producers. Journal of Public Health Medicine. 1995; 17:383-6.
- Hart JT, Dieppe P. Caring effects. Lancet. 1996; 347:1606-8
- Hart JT. Our feet set on a new path entirely: To the transformation of primary care and partnership with patients (Editorial). British Medical Journal. 1998; 317:1-2.
- Hart JT. Thoughts from an old GP. Lancet. 1998; 352:51-2
- Hart JT. The National Health Service as precursor for future society. 2002
Books
- Hart JT. The National Health Service: in England and Wales. Communist Party of Great Britain; 1970.
- Hart JT, Communist Party of Great Britain.The National Health Service in England and Wales: a marxist perspective. London Health Students Branch. Research and Study Group, Marxists in Medicine; 1971.
- Hypertension: community control of high blood pressure. First edition. 1980.
- Hart JT. An exchange of letters: hospital referrals. MSD Foundation; 1985.
- Hart JT, Stilwell B, Gray M. Prevention of coronary heart disease and stroke: a workbook for primary care teams. Faber; 1988.
- Hart JT, Pickering G. Hipertensión: su control en la comunidad. Doyma; 1989.
- Going for Gold: a new approach to primary medical care in the South Wales valleys. Swansea: Socialist Health Association; 1997.
- Going to the doctor. In: Cooter R, Pickstone J (eds). Medicine in the 20th Century. Amsterdam: Harwood Academic Publishers; 2000. p. 543-58.
- Hart JT, Savage W, Fahey T. High Blood Pressure at Your Fingertips: The Comprehensive and Medically Accurate Manual on How to Manage Your High Blood Pressure. McGraw-Hill Australia; 2003.
- Hart JT. Storming the Citadel: from romantic fiction to effective reality. In: Michael PF, Webster C (eds). Health and Society in Twentieth Century Wales. University of Wales Press; 2006. p.208-15.
See also
- Alex Tudor-Hart
- General PractitionerGeneral practitionerA general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
- Inverse care lawInverse care lawThe Inverse care law is the principle that the availability of good medical or social care tends to vary inversely with the need of the population served.Proposed by Julian Tudor Hart in 1971, the term has since been widely adopted.The law states that:...
- National Health ServiceNational Health ServiceThe National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...