Three Doctors in the driving seat? Reforms in NHS primary care and commissioning
-
Elke Heins
Abstract
In Chapter Three, Elke Heins examines NHS reforms in relation to primary care and commissioning, principally through the government’s Health and Social Care Act 2012. Taking effect in April 2013, the act reorganises the way that NHS services are commissioned. At a time when marketised ‘new public management’ experiments are being questioned by many governments around the developed world, the UK government is establishing a regulated market in which ‘any qualified provider’ from either the public or private sectors can compete for the right to be an NHS provider. Heins argues that this development needs to be understood in its historical context, with past marketisation measures having achieved at best ‘ambivalent’ outcomes. In the case of the 2012 Act, given growing budgetary pressures, doctors are likely to outsource their new-found ‘decision-making powers’, given to them in the market context, to private providers where possible.
Abstract
In Chapter Three, Elke Heins examines NHS reforms in relation to primary care and commissioning, principally through the government’s Health and Social Care Act 2012. Taking effect in April 2013, the act reorganises the way that NHS services are commissioned. At a time when marketised ‘new public management’ experiments are being questioned by many governments around the developed world, the UK government is establishing a regulated market in which ‘any qualified provider’ from either the public or private sectors can compete for the right to be an NHS provider. Heins argues that this development needs to be understood in its historical context, with past marketisation measures having achieved at best ‘ambivalent’ outcomes. In the case of the 2012 Act, given growing budgetary pressures, doctors are likely to outsource their new-found ‘decision-making powers’, given to them in the market context, to private providers where possible.
Chapters in this book
- Front Matter i
- Contents iii
- Notes on contributors v
- Introduction xi
-
Contemporary debates and developments in the UK
- Introducing Universal Credit 3
- Reconciling fuel poverty and climate change policy under the Coalition government: Green Deal or no deal? 23
- Doctors in the driving seat? Reforms in NHS primary care and commissioning 47
- Financing later life: pensions, care, housing equity and the new politics of old age 67
-
Contributions from the Social Policy Association/East Asian Social Policy Research Network Conference of 2012
- It’s time to move on from ‘race’? The official ‘invisibilisation’ of minority ethnic disadvantage 93
- Corporations as political actors: new perspectives for health policy research 113
- Square pegs and round holes: extending existing typologies fails to capture the complexities of Chinese social policy 129
- The Earned Income Tax Credit as an anti-poverty programme: palliative or cure? 149
- Social policy and culture: the cases of Japan and South Korea 167
- Load-shedding and reloading: changes in government responsibility – the case of Israeli immigration and integration policy 2004–10 183
-
Themed section: work, employment and insecurity
- ‘What unemployment means’ three decades and two recessions later 207
- Precarious employment and EU employment regulation 227
- How do activation policies affect social citizenship? The issue of autonomy 249
- Modernising social security for lone parents: avoiding fertility and unemployment traps when reforming social policy in Northern Europe 271
- Women, families and the ‘Great Recession’ in the UK 293
- Index 315
Chapters in this book
- Front Matter i
- Contents iii
- Notes on contributors v
- Introduction xi
-
Contemporary debates and developments in the UK
- Introducing Universal Credit 3
- Reconciling fuel poverty and climate change policy under the Coalition government: Green Deal or no deal? 23
- Doctors in the driving seat? Reforms in NHS primary care and commissioning 47
- Financing later life: pensions, care, housing equity and the new politics of old age 67
-
Contributions from the Social Policy Association/East Asian Social Policy Research Network Conference of 2012
- It’s time to move on from ‘race’? The official ‘invisibilisation’ of minority ethnic disadvantage 93
- Corporations as political actors: new perspectives for health policy research 113
- Square pegs and round holes: extending existing typologies fails to capture the complexities of Chinese social policy 129
- The Earned Income Tax Credit as an anti-poverty programme: palliative or cure? 149
- Social policy and culture: the cases of Japan and South Korea 167
- Load-shedding and reloading: changes in government responsibility – the case of Israeli immigration and integration policy 2004–10 183
-
Themed section: work, employment and insecurity
- ‘What unemployment means’ three decades and two recessions later 207
- Precarious employment and EU employment regulation 227
- How do activation policies affect social citizenship? The issue of autonomy 249
- Modernising social security for lone parents: avoiding fertility and unemployment traps when reforming social policy in Northern Europe 271
- Women, families and the ‘Great Recession’ in the UK 293
- Index 315
