Back to the future? Lessons on the pro-competitive regulation of health services.
The enactment of the Health and Social Care Act 2012 can be seen as a 'paradigm-oriented' policy transfer of the model of utilities regulation in the UK. This article draws on the literature on infrastructure regulation in order to analyse this transfer. Taking a long view on attempts to introduce competition into health services in England, it points to a number of challenges of liberalisation, corresponding to those arising in infrastructure sectors. Using a framework drawn from utilities, it analyses these under the headings of: (a) market structure; (b) allocation of regulatory authority; and (c) decision-making style. It suggests that the lens of utilities regulation is a useful one for analysing the NHS reforms, and clearly shows the difficulty in establishing workable competition in the sector.
School of Law, University of Sheffield, Bartolomé House, Winter Street, Sheffield S3 7ND, UK.
Lindsay
L
Stirton
D004465:Economic Competition; D033161:Government Regulation; D018166:Health Care Reform / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006801:Humans; D013222:State Medicine / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006113:United Kingdom
National Health Service; competition, liberalisation; policy transfer; pro-competitive regulation; utilities