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Learning from the NHS Internal Market: A Review of the Evidence

BMJ 1999; 318 doi: (Published 20 February 1999) Cite this as: BMJ 1999;318:543
  1. Chris Ham, director
  1. Health Services Management Centre, University of Birmingham

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    Julian Le Grand, Nicholas Mays, Jo-Ann Mulligan

    King's Fund, £17.95, pp 196

    ISBN 1 8571 7215 9

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    The reforms introduced to the NHS in 1991 have attracted enormous attention from within the United Kingdom and outside. The attempt to make the NHS more responsive and efficient by requiring hospitals and other providers to compete for resources was one of the last acts of Margaret Thatcher before she was replaced by John Major. Researchers have investigated various aspects of the NHS internal market, and this book synthesises the results.

    The most surprising conclusion is that the market seems to have had relatively little measurable impact. The authors …

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