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Purchasing in the NHS: administered or market contracts?

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Changes in Health Care

Abstract

Contract appears to be enjoying a renaissance in contemporary Britain. The legal theorist Patrick Atiyah (1995) has argued that the return to liberal market policies after 1979 was reflected in a revival of classical contract principles: that, as the wisdom of collective and bureaucratic decision making was challenged, the domain of activities covered by contract expanded at the expense of public regulation. Atiyah is concerned primarily with de-regulation and the resurgence of the doctrine of freedom of contract in private markets. However, if anything, ‘contractualisation’ has had an even more profound impact on the public services, which are undergoing the most radical re-structuring seen since the 1940s. The increasing scope of the contract principle is apparent both in the growth of ‘contracting out’ since the early 1980s, and experiments with internal markets and other quasi-market variants in the 1990s (Harden, 1992; Le Grand and Bartlett, 1993; Harrison, 1993; Vincent-Jones, 1994a; 1994b; Hudson, 1994; Tarn, 1994). ‘Market testing’, ‘franchising’ and ‘management contracts’ are other specific mechanisms that have developed out of competitive tendering.

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Authors
  1. David Hughes
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  2. Lesley Griffiths
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  3. Jean McHale
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Editor information

Editors and Affiliations

  1. De Montfort University, UK

    Paul Anand (Reader in Decision Theory) (Reader in Decision Theory)

  2. City University, London, UK

    Alistair McGuire (Professor of Health Economics, Research Associate) (Professor of Health Economics, Research Associate)

  3. Oxford Health Economics Group, UK

    Alistair McGuire (Professor of Health Economics, Research Associate) (Professor of Health Economics, Research Associate)

Copyright information

© 1997 David Hughes, Lesley Griffiths and Jean McHale

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Hughes, D., Griffiths, L., McHale, J. (1997). Purchasing in the NHS: administered or market contracts?. In: Anand, P., McGuire, A. (eds) Changes in Health Care. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-13710-7_4

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