After the internal market: public ownership or poisoned chalice?
This article examines the reasons why the internal market failed to gain public acceptance and looks beyond the popular view which argued the non-acceptance was a result of the "two tier" service and increased bureaucracy. It compares the experience of customers in the internal market with those of other public services that have undergone privatization. The article concludes that differences in the range and pattern of the services provided by the NHS led the public to a lower level of understanding regarding improvements and efficiency. The benefits of the market in other once public services were more transparent and there were greater incentives to accept the change. The article recommends that the clinicians involved in the management of primary care groups should learn the lessons of the internal market because users are ill-equipped for the next stage of healthcare reform as they were for the last.
Jones
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Essex Rivers Healthcare NHS Trust, Colchester, UK.
D001294:Attitude to Health; D004465:Economic Competition; D017598:Efficiency, Organizational; D006801:Humans; D011787:Quality of Health Care; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom