School of Management

The Centre for Public Services Organisations

“Moving towards the market again: the challenges of supply side reform in recent English healthcare policy”

Dr Pauline Allen, London School of Hygiene and Tropical Medicine


While the participation of independent health care providers in publicly funded healthcare systems is not unusual in many countries, since the inception of the National Health Service in 1948, the vast majority of care for NHS patients outside general practice has been delivered by public bodies.

This paper will give an account of how the government came to change this policy by opening up the supply side to a wider diversity of providers. The aims and results of the previous internal market experiment give the context to this policy development, and may help to explain current policy. The wide ranging nature of current system reforms are discussed before concentrating on the supply side reforms in more detail.

As well as outlining several notable aspects of these reforms (e.g. for profit surgery centres), the objectives of the policy to increase provider diversity are examined, and the challenges raised by these changes are discussed. I will argue that the government is too optimistic about the benefits, and insufficiently concerned about possible undesirable consequences.

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Time and Location

Date: 13th February 2008

Venue: MX01, Moore Annexe