Financial incentives, competition and a two tier service: lessons from the UK National Health Service internal market.
The experience of General medical practitioner (GP) fundholding is analysed for evidence of the response by family doctors to financial incentives. An analysis of consultant outreach, the local provision of out-patient services, in Scotland finds little evidence of a response, based on comparing the experience of fundholders with non-fundholders. At least in the case of hospital based services, financial incentives seem to be of secondary importance. Financial incentives for such services depend on consultant compliance which, arguably, was missing when it came to creating a two-tier service which deliberately favoured patients from fundholding practices.
Milne
Robin G
RG
Department of Economics, University of Glasgow, Glasgow G12 8RT, Scotland, UK. r.g.milne@socsci.gla.ac.uk
Torsney
Ben
B
D002017:Budgets; D003625:Data Collection; D004465:Economic Competition; D005194:Family Practice / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D008511:Medicine / Q000145:classification / Q000706:statistics & numerical data*; D010816:Physician Incentive Plans / Q000191:economics*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data*; D012052:Reimbursement, Incentive; D040841:Resource Allocation / Q000191:economics / Q000379:methods; D012606:Scotland; D013038:Specialization; D013222:State Medicine / Q000191:economics*