Name Julian Hart | Spouse Mary Thomas (m. 1963) | |
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Role Registered medical practitioner Books The Political Economy of Health Care, Feasible Socialism, Prevention of Coronary Heart Disease and Stroke, Hypertension Parents Alexander Tudor-Hart, Alison Macbeth Similar People Barbara Stilwell, Muir Gray, George Fenton | ||
Alan Julian Macbeth Tudor-Hart (born 9 March 1927), commonly known as Julian Tudor Hart, is a British doctor who worked as a general practitioner (GP) in Wales for 30 years. He was involved with research and is the author of many books and scientific articles.
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Early life
Hart was born in London on 9 March 1927, the son of Dr Alexander Tudor-Hart and Dr Alison Macbeth. He studied medicine at Cambridge University and in London, graduating in 1952.
He is a descendent of American businessman Frederic Tudor and Ephraim Hart, a Bavarian Jew who became a prominent merchant in New York, and was reportedly partners with John Jacob Astor. The name was originally Hirz.
His paternal grandfather, the Canadian artist Percyval Hart, married his Polish-French cousin Éléonora Délia Julie Aimée Hart Kleczkowska, and later changed the family surname to Tudor-Hart. Kleczkowska was the daughter of diplomat Michel Alexandre Cholewa, comte Kleczkowski (Michał Kleczkowski; 1818-1886) and granddaughter of Julie Sobieska, a direct descendent of John III Sobieski, king of Poland in the 17th century.
He was a member of the Sigerist Society from 1947 to 1955.
Hart joined the Communist Party of Great Britain, following his father Alex, and stood unsuccessfully as the CPGB candidate for Aberavon at the 1964, 1966 and 1970 general elections.
Career
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. Hart became involved in epidemiological research, with Richard Doll and Archie Cochrane. He is a passionate advocate of the National Health Service and of socialism. He is President of the Socialist Health Association.
He is a Fellow of the Royal College of General Practitioners (RCGP) and the Royal College of Physicians (RCP).
In 2006, he was awarded the inaugural Discovery Prize by the RCGP 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."
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 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 economy 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."