julian tudor hart

Originator of the inverse care law, but not just to describe unequal provision of health care, but a call to action and for change

Julian Tudor Hart was born in 1927 into a highly political, socialist  family with his father working with the International Brigades in Republican field hospitals in the Spanish Civil Ward. He studied first at Queens’ College, Cambridge, in 1947 and then at St George’s Hospital in London, where he qualified in 1952. After a series of hospital jobs took up the post of a GP in Notting Hill in London where his list comprised of many socially disadvantage migrants and high profile left wing patients who were in transit through the city.

By 1960 Julian  moved to work with Archie Cochrane at the Medical Research Council Epidemiological Unit outside Cardiff in south Wales. And from there he took up a practice in the mining village of Glyncorrwg in the Upper Afan Valley  in 1961. Over that time he met and married Mary Thomas who became a major partner both personally, professionally and politically.

In 1971 his paper, The Inverse Care Law, was published in the Lancet. It pointed out that quality health care was inversely provided in relation to need with mismatch being more marked by the extend of market involvement in health care delivery. This was following by a long series of other learned papers and many books including A New Kind of Doctor,  The Political Economy of Health Care and Feasible Socialism, National Health Service Past, Present and Future.

Julian continued to he very politically active, first in the Communist Party and later in the Labour Party. He served on the local Glyncorrwg Urban District Council. He was a stalwart of the Social Health Association thought he eventually resigned from the organisation because of its rightward drift during the New Labour years. He was also active in the Royal College of General Practitioners where he served on its Council for a number of years and became a Fellow of the College.

Julian retired from active clinical practice in 1987 but he continued to lecture on a world stage and remained politically active in support of the NHS and socialist politics. As a person with a renaissance range of skills he also became an active gardener and engaged in wide range of craft activities.

Julian died on 1st July 2018.

A presentation of the inverse care law 50 years after Julian articulated it in the Lancet in 1971, can be found here

Brian Gibbons