This article examines the degree to which doctors, as members of an autonomous profession, function as organic intellectuals within capitalist society (Abercrombie and Urry, 1983) and, more generally, the complex and ambivalent relations that sustain their role within a 'service class'. It is in this context that the organization of medical care and its delivery in Britain will be addressed. In particular, the current and intended changes in the organization and control of hospital medicine within the NHS, notably the issues of medical audit, clinical budgeting and the role of the 'internal market'.
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