Healthcare providers in the English National Health Service: public, private or hybrids?
Allen, P. , Bartlett, W. , Perotin, V. , Matchaya, G. , Turner, S. and Zamora, B. (2011) Healthcare providers in the English National Health Service: public, private or hybrids? International Journal of Public and Private Healthcare Management and Economics, 1 (3). pp. 1-18. ISSN 2155-6423
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To link to this article DOI: 10.4018/ijpphme.2011070101
In recent years it has been noted that boundaries between public and private providers of many types of welfare have become blurred. This paper uses three dimensions of publicness to analyse this blurring of boundaries in relation to providers of healthcare in England. The authors find that, although most care is still funded and provided by the state, there are significant additional factors in respect of ownership and social control which indicate that many English healthcare providers are better understood as hybrids. Furthermore, the authors raise concerns about the possible deleterious effects of diminishing aspects of publicness on English healthcare. The most important of these is a decrease in accountability
Allen, P., Turner, S., Bartlett, W., Perotin, V., Matchaya, G. and Zamora, B. (forthcoming) “Provider diversity in the English NHS: a study of recent developments in four local health economies”, Journal of Health Services Research & Policy Allen, P. and Jones, L. (2011) ‘Increasing the diversity of health care providers’ in Mays, N. and Dixon, A. (eds) Understanding New Labour’s quasi-market reforms of the English NHS London, The King’s Fund Allen, P., Bartlett, W., Perotin, V., Zamora, B. and Turner, S. (2011a) ‘New forms of provider in the English National Health Service’ Annals of Public and Cooperative Economics 82:1 77-95 Allen, P., Wright, J., Keen, J., Dempster, P., Townsend, J., Street, A., Verzulli, R. (2011b) Investigation of the governance of NHS Foundation Trusts Final report for NIHR SDO programme Allen, P. (2009) ‘Restructuring the NHS again: supply side reform in recent English Healthcare policy’ Financial Accountability and Management 25 (4) 343- 389 Allen, P. (2006) ‘New localism in the English NHS: what is it for?’ Health Policy 79: 244-52 Anderson, S. (2011) ‘Public, private, neither or both? Publicness theory and the analysis of healthcare organisations’ Social Science and Medicine Antonsen M. and Jorgensen, T. (1997) ‘The ‘Publicness’ of public organisations’ Public Administration 75 (2), 337-357 Ashton, T. (1998), 'Contracting for health services in New Zealand: a transaction cost analysis' Social Science and Medicine 46(3); 357-367 BDO Consulting (2011) ‘Private hospital spend’ reported in the Health Service Journal http://www.hsj.co.uk/news/finance/private-hospital-spend-varies-widely-study-shows/5033002.article Bartlett, W. (1991) “Quasi-markets and contracts: a markets and hierarchies perspective on NHS reform”, Public Money and Management, 11(3): 53-61. Bartlett, W. (1996) “The regulation of general practice”, International Journal of Health Planning and Management, 11(1): 3-18 Bartlett, W., Allen, P., Perotin, V., Turner, S., Zamora, B., Matchaya, G. and Roberts, J. (2011). Provider Diversity in the NHS: Impact on Quality and Innovation, Final report for NIHR Health Reforms Evaluation Programme. Bartlett, W. , Roberts, J. and Le Grand, J. (eds). (1998) A Revolution in Social Policy: Quasi-Markets in the 1990s, Bristol: Policy Press Besley, T. and Case, A. (1995) "Does Electoral Accountability Affect Economic Policy Choices? Evidence from Gubernatorial Term Limits," The Quarterly Journal of Economics, 110(3), 769-98 Bode, I. (2006) ‘Disorganised welfare mixes: voluntary agencies and the now governance regimes in Western Europe’ Journal of European Social Policy 16 (4) 346-59 Bromley by Bow (2011) website http://www.bbbc.org.uk/ Browne, J., Jamieson, L., Lewsey, J., Van der Meulen, J., Copley, L. and Black, N. (2008) 'Case-mix and patients' reports of outcome in Independent Sector Treatment Centres: Comparison with NHS providers', BMC Health Services Research, 78: 1-7. Buckingham, H. (2010) Hybridity, diversity and division of labour in the third sector: what can we learn from homelessness organisations in the UK? Working Paper 50 London: Third Sector Research Centre Circle (2011) website http://circlehealth.co.uk/ Clarke, J and Newman, J. (1997) The Managerial State London, Sage Clover, B. (2011) ‘Two foundation trusts breach private patient cap’ Health Service Journal 22 July Coursey, D. and Bozeman, B. (1990) ‘Decision making in public and private organizations: a test of alternative concepts of publicness’ Public Administration Review 50(5): 525-35 Croxson, B. (1999), Organisational Costs in the New NHS: an introduction to the transaction costs and internal costs of delivering health care Office Of Health Economics: London Defourny, J and Nyssens, M (2006) ‘Defining social enterprise’ in Nyssens, M (ed) Social Enterprise Routledge Oxford Department of Health (1989), Working for Patients White Paper Cm 555 London, HMSO Department of Health (1997) New NHS: Modern and Dependable White Paper London, HMSO Department of Health (2005), Health Reforms in England: update and next steps Department of Health, London Department of Health (2006) Health Reforms in England: update and commissioning framework July Department of Health: London Department of Health (2007) Third Sector Market Mapping Department of Health: London http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_065411 Department of Health (2010) NHS Outcomes Framework 2011/12 http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_123138.pdf Department of Health (2011) The Operating Framework for the NHS in England http://www.dh.gov.uk/en/Managingyourorganisation/Financeandplanning/Planningframework/index.htm Dillman, D. (1998) ‘Leadership in the American civil service’ in Hunt, M. And O’ Toole, B. (eds) Reform, Ethics and Leadership in Public Service Aldershot, Ashgate Publishing Ltd Dixit, A. (2002) “Incentives and organizations in the public sector: An interpretative review,” Journal of Human Resources, 37(4), Fall 696-727. Enthoven, A. (1999), In pursuit of an improving National Health Service Nuffield Trust, London Esping Andersen, G. (1990) The Three Worlds of Welfare Capitalism Cambridge: Polity Press & Princeton: Princeton University Press Estrin, S. and Pérotin, V. (1991) "Does ownership always matter?" International Journal of Industrial Organization, 9 (1), 55-72. Evers, A. (2005) ‘Mixed welfare systems and hybrid organisations: changes in the governance and provision of social services’ International Journal of Public Administration 28 (9) 737-48 Francis Inquiry (2010) Robert Francis Inquiry report into Mid-Staffordshire NHS Foundation Trust Department of Health http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_113447.pdf Haque, S. (2001) ‘The diminishing publicness of public service under current mode of governance’ Public Administration Review 61 (1): 65-82 Health and Social Care (Community Health and Standards) Act 2003 http://www.legislation.gov.uk/ukpga/2003/43/contents Health and Social Care Bill 2011 http://services.parliament.uk/bills/2010-11/healthandsocialcare.html Hickson, D., Butler, R., Cray, D., Mallory, G., Wilson, D. (1986) Top Decisions: strategic decision-making in organizations San Francisco: Jossey-Bass Hood, C. (1996) ‘Exploring variations in public management reform in the 1980s’ in Bekke, H., Perry, J. and Toonen, T. (eds) Civil Service Systems in Comparative Perspective Bloomington: Indiana University Press Hughes, O. (1998) Public Management and Administration London: Macmillan Keen, J. D. Light and N. Mays (2001), Public-Private Relations in Health Care (The King’s Fund, London) Laing (2008) Laing’s Healthcare Market Review 2007-08 London, Laing and Buisson Laville, J. L. and M .Nyssens. (2001), "Towards a theoretical socio-economic approach", in Borzaga, C. and Defourny, J. (eds), The Emergence of Social Enterprise London, Routledge Le Grand, J. and Bartlett, W. (eds) (1993) Quasi Markets and Social Policy London, Palgrave Macmillan Le Grand, J. N. Mays and J. Mulligan (eds) (1998) Learning from the NHS Internal Market A review of the evidence (King's Fund, London) Leat, D (1988’). Voluntary Organisations and Accountability London: National Council of Voluntary Organisations Monitor (2011a) Monitor’s website July 2011 http://www.monitor-nhsft.gov.uk/home/about-monitor/what-we-do Monitor (2011b) Monitor’s website July2011 http://www.monitor-nhsft.gov.uk/home/about-nhs-foundation-trusts/nhs-foundation-trust-directoryNational Health Service and Community Care Act 1990 Office of the Third Sector (2007) Third Sector Review London, Cabinet Office Peckham, S, Exworthy, M., Powell, M., Greener, I. (2005) Decentralisation, centralisation and devolution in publicly funded health services London, NHS Service Delivery and Organisation R&D Programme Perotin, V., Zamora, B., Reeves, R., Bartlett, W. and Allen, P. (under review) ‘Does hospital ownership affect patient experience? An investigation into public-private sector differences in England’ Perry, J., and Rainey, H. (1988) ‘ The public-private distinction in organization theory: a critique and research strategy’ The Academy of Management Review 13 (2) 182-201 Peters, G. (1993) ‘Searching for a role, the civil service in American democracy’ International Political Science Review 14(4); 373-86 Secretary of State for Health (2010) Equity and Excellence: Liberating the NHS White Paper Cm 7881 Secretary of State of Health (2011) Government response to the NHS Future Forum report 20th June http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_127444 Stark, D. (1996) ‘Recombinant property in Eastern European Capitalism’ American Journal of Sociology 101 (4) 993-1027 Third Sector Research Centre (2011) website accessed July 2011 http://www.tsrc.ac.uk/ Timmins, N. (2007) ‘NHS Trusts set up deals to avoid private patient caps’ Financial Times, 20 August http://www.ft.com/cms/s/0/eaee2e76-4eb4-11dc-85e7-0000779fd2ac.html#ixzz1G6tBdHr4 Tribal (2009) Social Enterprises Pathfinder Programme Evaluation Final Report London, DH Tuohy, C. (1999), Accidental logics : the dynamics of change in the health care arena in the United States, Britain and Canada (Oxford University Press, Oxford) Turner, S., Allen, P., Bartlett, W. and Perotin, V. (2011) ‘Innovation and the English National Health Service: A qualitative study of the independent sector treatment centre programme’ Social Science and Medicine 73.4: 522-529 Vincent-Jones, P. (2006), The new public contracting: regulation, responsiveness, relationality (Oxford University Press, Oxford) Williamson, O. (1985), The Economic Institutions of Capitalism (Free Press, New York)