23 May 2003
The government is creating a new NHS internal market and it is unclear whether it will lead to better patient care, the King's Fund claimed this week.
Ministers have consistently denied they are reconstituting the Conservatives' internal market. While care providers will compete, it will be on the basis of quality, not price, one of the defining features of the Conservative reforms of the early 1990s.
In a new report, Shaping the new NHS: can market forces be used for good?, the fund acknowledges that Labour's market is different and has potential.
Although current arguments have focused on foundation hospitals, other policy developments may have even more impact, the report notes. These include the introduction last month of a system whereby money follows patient choices between alternative providers.
'The environment is different now. Competition between hospitals and other providers is being based on the quality and number of operations. Information systems are much improved and regulation of providers is tighter,' said King's Fund director of health policy Jennifer Dixon.
But while market incentives may be appropriate for non-urgent care, it was unclear how competition based on quality would produce better care for patients with chronic conditions, she said. These patients are looked after by a number of different organisations but competition could prevent the collaboration needed for the best possible care, she said.
Dixon suggested that a more sophisticated approach could be developed.
'Two tracks may now be open for health policy: encouragement by government for a more contestable market for planned hospital services, and a different approach for chronic disease that still needs to be developed,' she added.
However, she warned that should Labour win the next general election and NHS modernisation is believed to be too slow, further reform may be deemed necessary.
PFmay2003
