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Dismantling the NHS?Evaluating the Impact of Health Reforms$
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Mark Exworthy, Russell Mannion, and Martin Powell

Print publication date: 2016

Print ISBN-13: 9781447330226

Published to University Press Scholarship Online: May 2017

DOI: 10.1332/policypress/9781447330226.001.0001

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date: 18 August 2017

Provider plurality and supply-side reform

Provider plurality and supply-side reform

Chapter:
(p.211) Eleven Provider plurality and supply-side reform
Source:
Dismantling the NHS?
Author(s):

Rod Sheaff

Pauline Allen

Publisher:
Policy Press
DOI:10.1332/policypress/9781447330226.003.0011

Not only healthcare financing but also its provision was nationalised when the NHS was founded. Besides guaranteeing access to healthcare, Bevan and the other founders also intended to – and eventually largely did – ‘level up’ a supply side comprised of diversely-owned providers which provided correspondingly diverse levels of service access, quality and responsiveness to healthcare needs. Since 1979 neo-liberal ‘reforms’ of the NHS have had a supply side component, that of introducing ‘provider plurality’ under which a range of differently-owned organisations provide NHS-funded services. In the circumstances that most NHS services have hitherto been provided by public organisations and professional partnerships, proposals for greater provider diversity mean shifting the proportion towards providers such as shareholder-owned, dividend-maximising firms, social enterprises, and co-operatives and mutuals. Whatever the effect on healthcare supply, such a contentions policy has already greatly increased the supply of euphemism, confusion and obfuscation in health policy debates. This chapter attempts to give an overview of the empirical patterns of development, and unpick some of the conceptual confusions.

Keywords:   NHS, provider plurality, healthcare, health policy, reforms

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