It looks as if the era of markets and competition within the NHS has come to an end. The vanguards and devolution experiments are challenging the traditional boundaries. Many pages of planning guidance contains no mention of competition – Monitor is being morphed into something else entirely. Commissioning as has been tried through its various guises is adapting further in different ways in different places. Integrated providers and hybrids of commissioner/provider are now possible. New kinds of organisational bodies could be taking over the role as strategic commissioner of integrated services. So – much thought is being given to future […]
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Tag Archives: reorganisation
I INTRODUCTION I am greatly flattered to be invited to deliver the 1998 annual lecture of the Office of Health Economics, partly on account of my distinguished predecessors, but also because this invitation provides an opportunity for a more explicitly historical perspective than is usual on these occasions. This year of the fiftieth anniversary of the National Health Service(NHS) is an especially appropriate opportunity for such an exercise. Building on the important insights provided by Sir Douglas Black who, in the 1994 OHE Annual Lecture,1 alluded to the fallibility of the reorganisation process, in this lecture I would like to […]
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