Public-private boundaries and the transformation of the NHS

Abstract

This article uses an examination of the changing boundaries between the public and the private in health-care to argue that developments of a transformative character are taking place in the NHS. Rather than focusing on principles such as comprehensiveness and universality, it considers the collectivism of funding and the production of health-care to be the central features of the NHS in 1948. It is these which are now being eroded. This exploration does not confine itself to policy measures but considers the changing political dynamic within and around the NHS and its changing culture to be significant factors in current and potential change.

Seventy Years of Privatizing the British National Health Service?

“…Esping‐Andersen : 19–21), and it is not clear if privatization is best regarded in quantitative (‘actuarial’) or qualitative terms (see e.g. Ruane ).…”

“…The final point concerns the ambiguous position of ‘independent contractors’ such as GPs, dentists, opticians and pharmacists, who are located at the public–private boundary (Keen et al . ; Ruane ), who can be seen as state provision and finance (cell 1) or private provision and state finance (cell 2). Keen et al .…”

“…Ranade and Haywood () claim that the distinctive contribution of the Conservative Government lay in the efforts to recast management structures, systems, norms and values in line with the perceived virtues of the private sector (cf. Ruane ; Lister ). They concluded that a form of privatization was introduced by defining a new private sector General Management model for NHS managers to follow.…”

“…They concluded that a form of privatization was introduced by defining a new private sector General Management model for NHS managers to follow. This is difficult to fit into the MEW model (Ruane ), and has clearer links with the publicness literature (e.g. Boyne ; Andrews et al .…”

New Labour and the third way in the British welfare state: a new and distinctive approach?

“…Many critics argue that there is a thin line between public-private partnerships and 'privatization' (e.g. Ruane, 1997). On the other hand, some Conservative 'public-private partnerships' such as the Assisted Places Scheme and nursery vouchers are to be abolished.…”