The National Health Service in the UK: from myths to markets

Abstract

This paper traces the introduction of economic principles into the NHS over the past 40 years. During this period the service has changed from one which specifically sought to distance the delivery of health care from homo-economicus to one which is increasingly shaped by economic motivation and market-oriented strategies. Three phases in this development are discussed: the administered phase 1948-74, the planning phase 1974-84, and the present management phase. Each phase required different systems of information to support the organization of the service according to the underlying beliefs and philosophy about the relevance of economics to health care. It is suggested that the impact of market provision of health care will need to be vigilantly monitored to ensure that standards of the nation's health care are effective and equitably distributed.