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Shopping Around? Consumerism and the Use of Private Accident and Medical Clinics in Auckland, New Zealand

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  • J R Barnett

    (Department of Geography, University of Canterbury, Christchurch, New Zealand)

  • R A Kearns

    (Department of Geography, University of Auckland, Auckland, New Zealand)

Abstract

In this paper we review the ideology of health care service users as consumerists within the context of the market-driven health care reforms of the New Right. We localise this discussion by examining the way in which the recent (since 1991) health reforms in New Zealand have incorporated this ideology and added impetus to earlier (unsuccessful) moves to bring corporate interests into the field of primary health care. We then test the contention that patients ‘shop around’ for doctors by examining the utilisation behaviour of patients at two recently developed private accident and medical clinics in Auckland, New Zealand. Our analysis of data from a sample of 205 patients suggests that, despite some price discounting by these clinics, patients appear to ‘shop around’ only modestly and largely use clinics because they are convenient and because of the perceived ambience of these new medical environments. We conclude that for those in more desperate financial circumstances, choices for health care continue to be made on the pragmatic basis of physical access. Although ‘doctor shopping’ may exist, health care reforms based on the assumption that this is widespread behaviour will do little to improve the access to, or quality of, care for those who need it most.

Suggested Citation

  • J R Barnett & R A Kearns, 1996. "Shopping Around? Consumerism and the Use of Private Accident and Medical Clinics in Auckland, New Zealand," Environment and Planning A, , vol. 28(6), pages 1053-1075, June.
    • Handle: RePEc:sae:envira:v:28:y:1996:i:6:p:1053-1075
    DOI: 10.1068/a281053
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    References listed on IDEAS

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    1. Charles M. Tiebout, 1956. "A Pure Theory of Local Expenditures," Journal of Political Economy, University of Chicago Press, vol. 64(5), pages 416-416.
    2. Kearns, Robin A. & Smith, Christopher J. & Abbott, Max W., 1991. "Another day in paradise? Life on the margins in urban New Zealand," Social Science & Medicine, Elsevier, vol. 33(4), pages 369-379, January.
    3. Lupton, Deborah & Donaldson, Cam & Lloyd, Peter, 1991. "Caveat emptor or blissful ignorance? Patients and the consumerist ethos," Social Science & Medicine, Elsevier, vol. 33(5), pages 559-568, January.
    4. Hays, Susan M. & Kearns, Robin A. & Moran, Warren, 1990. "Spatial patterns of attendance at general practitioner services," Social Science & Medicine, Elsevier, vol. 31(7), pages 773-781, January.
    5. Charny, M. & Klein, R. & Lewis, P. A. & Tipping, G. K., 1990. "Britain's new market model of General Practice: do consumers know enough to make it work?," Health Policy, Elsevier, vol. 14(3), pages 243-252, May.
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    Cited by:

    1. Neuwelt, Pat M. & Kearns, Robin A. & Browne, Annette J., 2015. "The place of receptionists in access to primary care: Challenges in the space between community and consultation," Social Science & Medicine, Elsevier, vol. 133(C), pages 287-295.

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