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Thursday, 11th December 2014

The Wrong Medicine: A Review of the Impacts of NHS Reforms in England

Source: New Economics Foundation (UK)

From Press Release:

Market-based reforms began in the 1980s, when support services were first contracted out, and continued in the 1990s, with the creation of an internal market for clinical services. In the 2000s, patients were allowed to choose where they received some treatments; prices were attached to units of completed healthcare; the first privately owned centres were established to take on NHS business; some hospitals became independent foundation trusts; and private companies built most new hospitals, recovering their investment by renting them back to the NHS for 30 years or more.

From 2010, under the Coalition government, the speed of change intensified. The health budget was drastically constrained, leaving the NHS in a mounting financial crisis with shrinking resources to meet expanding volumes of need. The Health and Social Care Act introduced the biggest set of changes ever imposed on the NHS. It removed from government the primary responsibility for providing healthcare, established open competition as the new norm, and aimed to turn all NHS trusts into foundation trusts, independent of government control.

While there is now a “level playing field” between sectors, large commercial organisations have advantages in the new NHS marketplace and are winning more contracts. The Transatlantic Trade and Investment Partnership (TTIP), due for completion in 2015, will remove trade barriers between the European Union and the US. Unless the NHS is excluded from TTIP, any future government trying to return privatised health services to public hands will risk severe financial penalties....

The claim that increased competition can improve both efficiency and quality of care is a central justification of market-based reforms and the Health and Social Care Act. Yet we could find no sound evidence to support it. Academic studies, including systematic reviews on both sides of the Atlantic, find the effects of market mechanisms and privatisation in healthcare systems have largely inconclusive or negative effects on quality and equity in healthcare. International comparative studies of healthcare systems have given high rankings to the UK and low rankings to the US.

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Having begun his career in academic libraries, Adrian Janes has subsequently worked extensively in public libraries, chiefly in enquiry work as an Information Services librarian. In this role he has had particular responsibility for information from both the UK Government and the European Union. He wrote a detailed report on sources for the latter which was published by FreePint in 2007, and has contributed articles to FreePint and ResourceShelf. He is involved in training in information literacy and the use of online reference resources.

A Contributing Editor to DocuTicker, he also write reviews for Pennyblackmusic.

More articles by Adrian Janes »



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