Charlotte Williamson's piece on Alford's theoretical political model1 provides a seductive analysis which she is applying to the flux happening now within health service organisation in the UK. However it should be acknowledged that this is a political theory. By describing clinician's interests as ‘dominant’, the use of language alone implies that their interest should be moderated or brought down.
Alford developed his theory to effect change in 1970s US health care, when many …