OECD health policy: New effort to privatize health care in England

John Lister

About John Lister

John Lister, European web coordinator for AHCJ, has been a journalist for 35 years, specializing in reporting health policy in England. He is the author of "Health Policy Reform: Driving the Wrong Way?," a critique of market-style reforms, and "The NHS After 60: for Patients or Profits?," a critical history of the British National Health Service.

The new coalition government in the United Kingdom is expected to resume the process of outsourcing of primary care and community services, which employ about 250,000 people. Until recently these services were directly delivered in England by local Primary Care Trusts (PCTs) but they will now be opened up to bids from “any willing provider,” including for-profit companies.

OECD health policy: Seeking evidence for market reforms

This controversial policy, initiated under Tony Blair’s government, was temporarily halted last October by then-Health Secretary Andy Burnham.  Burnham tried to establish the public sector National Health Service as a “preferred provider,” but both parties now in the ruling coalition nixed the idea.

The Labour government also established a new “NHS Cooperation and Competition Panel,” almost entirely staffed by proponents of private sector interests, which was designed to act as an appeals board if private providers are excluded from the bidding process.  Health trade unions as well as the Royal College of Nursing and the British Medical Association oppose this move.

Making health care into a market

The creation of local markets in health care, in which the existing NHS hospitals and providers would face external competition underlies the approach of the New Labour government’s reforms under Tony Blair and now revived by the new Conservative-Liberal Democrat coalition,  Primary Care Trusts, as commissioners of services for their local population, would be required to create and stimulate  local “markets”, and encourage the entry of new providers, theoretically to ensure the best value for the government’s money.

But in many areas there seems to be little appetite for private providers to challenge NHS services.  Time will tell if this latest move toward privatizing some aspects of the National Health Service will bear fruit or will simply be expensive experiments in the end.

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