In Defiance of the Evidence: Conservatives Threaten to “Reform” Away England's National Health Service

Lister, John

doi:10.2190/hs.42.1l

Cited by 7 publications

(16 citation statements)

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“…While the Act's supporters argue that competition will provide innovation, better management, and improved quality (Le Grand, 2013), its critics argue that it will exacerbate health inequalities (Hunter, 2013) and service rationing (Lister, 2012), end comprehensive public-sector health service provision (Pollock and Price, 2011), and worsen democratic accountability (Davies, 2013). Peedell (2011) shows that the Act's objectives fit most commonly accepted definitions of privatisation, and Moody goes as far as to say that, in the future, "there will be no fully state-owned providers" (2011: 428-429).…”

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confidence: 99%

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

Krachler

Greer

2015

Social Science & Medicine

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Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. England's Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the implementation of the 2012 Act.By generating a theoretical framework on the conditions of profitability we seek a better understanding of the conditions under which marketisation leads to privatisation. We find that significant barriers to profit-making remain after the reforms, including a top-down squeeze on prices, uncertainty in market rules, state dominance of funding and provision, and failures to depoliticise the market. These factors restrict privatesector involvement by frustrating profit-making. Where profits are made they are through reduced unit costs and high volumes by a longstanding incumbent in a particular market segment. This, however, restricts marketisation by reinforcing entry barriers Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. 1 England's Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the implementation of the 2012 Act. Suggested Citation Krachler, N., & Greer, I. (2015). When does marketisation lead to privatisation? Profit-making in English healthBy generating a theoretical framework on the conditions of profitability we seek a better understanding of the conditions under which marketisation leads to privatisation. We find that significant barriers to profit-making remain after the reforms, including a top-down squeeze on prices, uncertainty in market rules, state dominance of funding and provision, and failures to depoliticise the market. These factors restrict private-sector involvement by frustrating profit-making. Where profits are made they are through reduced unit costs and high volumes by a longstanding incumbent in a particular market segment. This, however, restricts marketisation by reinforcing entry barriers.

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confidence: 99%

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

Krachler

Greer

2015

Social Science & Medicine

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“…This alternative point of view at that time was that HSCA2012 would privatise and eventually put pay to the NHS as we know it (Pollock 2011, Pollock 2012). The acts' critics argue that HSCA2012 has been responsible for deepening health inequalities (Hunter 2011), has led to rationing of services (Lister 2012) Many commentators trace any deficiencies in hospital care in England back to HSCA2012. A lot has been said and written about the organisational and structural changes brought about by the HSCA2012 and participation of the private sector in the delivery of secondary and tertiary services (Speed 2013, Marshall 2014.…”

Section: Discussionmentioning

confidence: 99%

The effects of the NHS reforms on quality of care

Mofidi

Marrow

2017

British Journal of Healthcare Management

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Usage of any items from the University of Cumbria's institutional repository 'Insight' must conform to the following fair usage guidelines.Any item and its associated metadata held in the University of Cumbria's institutional repository Insight (unless stated otherwise on the metadata record) may be copied, displayed or performed, and stored in line with the JISC fair dealing guidelines (available here) for educational and not-for-profit activities provided that• the authors, title and full bibliographic details of the item are cited clearly when any part of the work is referred to verbally or in the written form• a hyperlink/URL to the original Insight record of that item is included in any citations of the work • the content is not changed in any way• all files required for usage of the item are kept together with the main item file. You may not• sell any part of an item• refer to any part of an item without citation • amend any item or contextualise it in a way that will impugn the creator's reputation• remove or alter the copyright statement on an item.The full policy can be found here. Alternatively contact the University of Cumbria Repository Editor by emailing insight@cumbria.ac.uk. British Journal of Healthcare ManagementQuality of care provided by the Shelford Group of NHS trusts before and after the enactment of Health and Social Care Act of 2012 (HSCA2012).--Manuscript Draft-- Abstract: Health and Social Care Act of 2012 (HSCA2012) has altered the operational and business environment within which NHS trusts in England operate. Shelford group are the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the quality of care provided by the Shelford group. Annual quality of accounts produced by each of the Shelford group NHSTs for financial years FY 12-13, FY 13-14 and FY 14-15 were reviewed. The key performance indicators for each organization were collected and classified in line with NHS Quality Outcomes Framework (QOF). KPIs for the period just prior to enactment of HSCA2012 (FY12-13) were compared with the corresponding values for the period after the enactment of HSCA2012.The benchmarking model used in the study was validated against the Hospital Intelligent Monitoring Report (HIMR) used by the Care Quality Commission. The clinical services provided by the Shelford group increased year on year by 7.5%, 6.4% and 4% respectively . In the FY14-15 Shelford group collectively provided 14,735,000 patient care episodes There was no significant difference in the value of the KPIs before and after enactment of HSCA2012 along the 6 domains defined by the NHS-QOF. Good correlation was observed between the benchmarking method used in the study compared with the HIMR (r2=0.86).The quality of care provided by the Shelford group of NHS trusts did not change following enactment of HSCA2012.Suggested Reviewers:Response to Reviewers: Dear Sir/Madame This manuscript has been rewritten significantly to take the reviewers comments into account. The following change...

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“…Lister () writes that Lansley's plans require all NHS trusts to become autonomous FTs, with a longer‐term goal of getting FTs ‘off the NHS balance sheet’, floating them off as non‐profit ‘social enterprises’ (cell 3). He continues that ‘this experimental policy would, if carried through, effectively privatize virtually all the provision of health services in England by 2014 (Lister : 146).…”

Section: Period 4: Conservative/liberal Democrat Coalition (2010–15)mentioning

confidence: 99%

“…Second, they pointed to the potential for key decisions such as rationing to be handed over to private sector management consultancies such as McKinsey and United Health (Lister ; Reynolds et al . ).…”

Section: Period 4: Conservative/liberal Democrat Coalition (2010–15)mentioning

confidence: 99%

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Seventy Years of Privatizing the British National Health Service?

Powell

Miller

2015

Soc Policy Adm

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The existence of different and conflicting definitions and different types, but few clear measures, of privatization has contributed to different interpretations of the extent of privatization in the almost 70-year history of the British National Health Service (NHS). This article aims to examine the extent of privatization in the NHS over successive policy chronologies through the lens of the 'three dimensional' approach of the Mixed Economy of Welfare. We find that whilst privatization in the NHS is not new, the generally accepted view that it has increased in recent years appears valid, although precision is difficult due to the lack of a generally accepted typology or measure.

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In Defiance of the Evidence: Conservatives Threaten to “Reform” Away England's National Health Service

Cited by 7 publications

References 8 publications

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

The effects of the NHS reforms on quality of care

Seventy Years of Privatizing the British National Health Service?

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