For the past 20 years, the healthcare policies of
successive governments have focused to a large extent on
developing a market within the NHS in England. The
reasoning behind these moves primarily centred on the
hypothesis that if competition, in theory and in
practice, has proved to be the greatest single spur to
efficiency, quality and innovation in other industries,
could it not have the same effect in the NHS? Refusing
Treatment: the NHS and market-based reform presents the
findings of a year-long, in-depth study into whether and
why the NHS market has achieved such results. The study
is based on 46 interviews with executives at NHS
(foundation) trusts, PCTs, practice-based commissioners
and private sector providers, across three health
economies in England. Isolated examples of the market
having significant positive effects were found. However,
by and large, the market is yet to have its intended
impact on providers and bring about the anticipated
benefits on any meaningful and systematic scale.This is
less because the concept of a market is flawed when it
comes to the NHS, and more because the market is being
distorted and stifled; in particular, by the closed
culture of the NHS and powerful, emotive notion of the
'NHS family'. In unprecedentedly tight financial times
for the NHS, these findings carry policy implications
that should not be ignored. |
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