Old people as users and consumers of healthcare: a third age rhetoric for a fourth age reality?

This paper is concerned with the emergence of consumerism as a dominant theme in the culture surrounding the organisation and provision of welfare in contemporary societies. In it we address the dilemmas produced by a consumerist discourse for older people's healthcare, dilemmas which may be seen as the conflicting representations of third age and fourth age reality. We begin by reviewing the appearance of consumerism in the recent history of the British healthcare system, relating it to the various reforms of healthcare over the last two decades and the more general development of consumerism as a cultural phenomenon of the post World War II era. The emergence of consumer culture, we argue, is both a central theme in post-modernist discourse and a key element in the political economy of the New Right. After examining criticisms of post-modernist representational politics, the limitations of consumerism and the privileged position given to choice and agency within consumerist society, we consider the relevance of such critical perspectives in judging the significance of the user/consumer movement in the lives of retired people.