BMJ  2008;336:979 (3 May), doi:10.1136/bmj.39562.531308.DB

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Move to split role of healthcare purchaser and provider may have to be abandoned, expert says

¹ Financial Times

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

Plans to turn the NHS into a "world class" commissioner of health care are highly unlikely to work, a former health department head of strategy has warned.

But if the government does succeed, its achievement will be "a world first," said Chris Ham, professor of health services management at Birmingham University and former head of the Department of Health’s strategy unit.

Separating the role of purchasing from the provision of health care has now been tried in various ways in several European countries, in New Zealand, and in the United States, Professor Ham said in a paper on international experience of the exercise. It was introduced into the NHS in 1991 by the then health secretary, Kenneth Clarke. But "in no system is commissioning done consistently well," Professor Ham said, and the government faces "huge obstacles" to make it work.

A better answer may be to go for competing integrated . . . [Full text of this article]

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