Ten The English NHS as a market: challenges for the Coalition government
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Nicholas Mays
Abstract
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.
Abstract
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.
Kapitel in diesem Buch
- Front Matter i
- Contents iii
- Notes on contributors v
-
Symposium on the Coalition government
- Conservative social policy: from conviction to coalition 7
- Something old and blue, or red, bold and new? Welfare reform and the Coalition government 25
- The Conservative Party and the ‘Big Society’ 45
- The age of responsibility: social policy and citizenship in the early 21st century 63
- Debating the ‘death tax’: the politics of inheritance tax in the UK 85
- The debate about public service occupational pension reform 103
- Welfare to work after the recession: from the New Deals to the Work Programme 127
- Lone parents and the Conservatives: anything new? 147
- A treble blow? Child poverty in 2010 and beyond 165
- The English NHS as a market: challenges for the Coalition government 185
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Education in international context
- Citizenship education in international perspective: lessons from the UK and overseas 211
- “You’re only going to get it if you really shout for it”: education dispute resolution in the 21st century in England 233
- A sin of omission: New Zealand’s export education industry and foreign policy 257
- Student security in the global education market 281
- Exporting policy: the growth of multinational education policy businesses and new policy ‘assemblages’ 303
- Index 323
Kapitel in diesem Buch
- Front Matter i
- Contents iii
- Notes on contributors v
-
Symposium on the Coalition government
- Conservative social policy: from conviction to coalition 7
- Something old and blue, or red, bold and new? Welfare reform and the Coalition government 25
- The Conservative Party and the ‘Big Society’ 45
- The age of responsibility: social policy and citizenship in the early 21st century 63
- Debating the ‘death tax’: the politics of inheritance tax in the UK 85
- The debate about public service occupational pension reform 103
- Welfare to work after the recession: from the New Deals to the Work Programme 127
- Lone parents and the Conservatives: anything new? 147
- A treble blow? Child poverty in 2010 and beyond 165
- The English NHS as a market: challenges for the Coalition government 185
-
Education in international context
- Citizenship education in international perspective: lessons from the UK and overseas 211
- “You’re only going to get it if you really shout for it”: education dispute resolution in the 21st century in England 233
- A sin of omission: New Zealand’s export education industry and foreign policy 257
- Student security in the global education market 281
- Exporting policy: the growth of multinational education policy businesses and new policy ‘assemblages’ 303
- Index 323
