Consumer as king in the NHS

Over the last two decades, in response to political and financial pressures, the NHS has been subjected to considerable changes in its organisation. There is increasing emphases on containing the costs of hospital provision and making the treatment available from hospitals more responsive to consumers’ needs. “New” public sector management (NPM) philosophy clearly reflects an ideological shift toward newly valued entrepreneurial attitudes and behaviours, where patients and health service‐users are re‐defined as “customers” and “consumers”. Through a consideration of the recent changes, this paper will argue that the increasing emphasis on efficiency, cost‐cutting and most especially consumer satisfaction has transformed how nurses manage their emotions at work, adding new dimensions to their caring role. Nurses now find themselves having to present the detached, calm, but caring, face of the health professional whilst also having to present a smiling face to patients who now behave as demanding customers.