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One health policy approach to addressing the demographic challenge of an ageing population with high levels of chronic disease is to encourage self-care. At the same time there have been shifts in the organisation of health services and practitioner-patient relations, to a model of 'patient-centred' care. The emergence of the internet over the last twenty years has coincided with these shifts in policy priorities to the self-management of long-term conditions and the centrality of the informed, expert user. Current policy seeks to achieve user empowerment through harnessing technology to provide 'greater choice and control'. In this paper we assess the extent to which this aim is realistic from an examination of health queries submitted to an online enquiry service. Our data supports other research which shows that while empowerment does occur in the use of online health services, this is constrained and context dependent. Current health reforms in England are leading to a fragmented, marketised NHS, where competitive choice designed to drive quality improvement and efficiency savings is informed by transparent performance data and patient experience ratings, and with the notion of an empowered health consumer at its centre. It is therefore essential that policy makers are aware of the limits to online health consumer empowerment. © 2012 Policy Studies Organization.

Original publication




Journal article


Policy and Internet

Publication Date