The English NHS as a market: challenges for the Coalition government

Mays Nicholas

in Social Policy Review 23

Published by Policy Press

Published in print June 2011 | ISBN: 9781847428301
Published online March 2012 | e-ISBN: 9781447303503 | DOI:
The English NHS as a market: challenges for the Coalition government

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This chapter assesses the implications of the Coalitions's plans to restructure the National Health Service (NHS) in England. It explains that the plans involve taking another big step towards an NHS based on a publicly funded regulated market, by abolishing strategic health authorities and replacing primary care trusts with GP-led commissioning consortia. It evaluates the evidence on the market changes introduced by New Labour governments, arguing that these have had some success compared to the impact of additional resources and the setting and enforcement of targets. It notes however, that the absence of any regional intermediary organisations in the Coalition's plans may lead to inefficient duplication, fragmentation and destabilization, given the tendency towards market failure in healthcare. It opines that undertaking the scope and pace of reform envisaged in a context of restricted financial resource is a risky process, and a more complete, more competitive, NHS market could have negative effects on equity.

Keywords: Coalition's plans; restructure; National Health Service; England; GP-led commissioning consortia; New Labour; healthcare; equity

Chapter.  7446 words.  Illustrated.

Subjects: Social Research and Statistics

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