BMJ  2005;331:1141-1142 (12 November), doi:10.1136/bmj.331.7525.1141

Education and debate

The NHS revolution: health care in the market place

Use of private health care in the NHS

Nicholas Timmins, public policy editor1

1 Financial Times, London SE1 9HL Nick.Timmins@FT.com

The UK government is committed to use independent providers to help reduce waiting times for NHS services. Will the benefits outweigh the risks?

The first 150 words of the full text of this article appear below.

Introduction

The NHS is going through the biggest revolution in the way its services are delivered since its foundation in 1948. The key ingredients are payment by results, patient choice, foundation hospitals, and the deliberate injection of independent treatment centres and private sector providers into the NHS. Between them, they add up to the creation of a supplier market in UK health care. Surrounded by a clutch of new inspectors and regulators—the Healthcare Commission, Monitor (which oversees foundation hospitals), the National Institute for Health and Clinical Excellence, and others—these changes offer a far more sophisticated but also a much more open and aggressive version of the "internal market" that the Conservatives tried in the 1990s.

Of the various elements in the current reforms, arguably the most important is payment by results. This involves the creation of a national tariff for treatment that allows money to follow the patient and is based . . . [Full text of this article]

Controversial reform

Rationale for independent treatment centres

Effect on NHS services


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