The Impact of Contracting Out in the NHS

Abstract

The provision of services by private contractors in the National Health Service rather than by direct labour is not a recent phenomenon. Certain services, eg. the erection and repair of buildings, have been performed by contractors in the majority of health authorities. In some instances, catering and domestic services have been performed by outside contractors for a number of years (although this has been the case only in a very small minority of hospitals). What is novel is a policy which says health authorities must invite companies to tender competitively against their own in‐house services, and choose the tender which is the least costly.

Going privately: partnership and outsourcing in UK public services

“…A second lesson was that while greater use of the market and contracts may bring about an apparent reduction in costs, these savings may be offset by less readily quantifiable costs such as damage to the quality of services provision, or an erosion of the public sector ethos among workers (Corby and White 1999;Grimshaw et al 2000;Mailly 1986). Despite the great importance of this issue, it has received relatively little research attention (although see CIPD 2001), perhaps because it is ideologically challenging to the New Labour commitment to public private partnerships as the favoured means of improving public sector services provision.…”

Commissioning personalised care in the English adult social care sector: an action research model to support leadership development

“…Early models of commissioning were based on contracting out, and separation of the purchaser, provider roles. Health or local authorities were forced to invite companies to tender competitively against their own in-house services, and choose the tender which was the least costly (Mailly, 1993). Goddard et al (1997) note that in contracting out emphasis was placed on the contract itself.…”