Coalition policy towards the NHS: past contexts and current trajectories – January 2011

Posted on March 18, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Coalition policy towards the NHS: past contexts and current trajectories – January 2011
by Martin Gorsky

“Executive summary
The Coalition programme for the NHS broadly continues the trajectory of policy development pursued by both parties since 1989. Once adopted it will provide the clearest test yet of the internal market model begun under Prime Ministers Margaret Thatcher and John Major and developed by New Labour.
The current funding settlement will see the rate of real increase severely constrained over four years. This is historically unprecedented.
History suggests several risks attach to rapid adoption of the planned structural reform. These relate to doctors’ ability and willingness to lead consortia, the reduction of managerial capacity, and unresolved weaknesses of commissioning.
The state’s retreat from centralised control may also prove contentious. ‘Top-down’ targets and tough bureaucratic rationing have been effective tools in certain respects.
Proposals for an autonomous NHS Commissioning Board must confront the ‘Enoch Powell problem’ of how to square non-ministerial management with political accountability in a single-payer system.”  …continues on the site

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