Abstract

The Coalition government’s plans for reform are meant to transform the NHS into a more privately run, competitive system, raising the question as to whether or not the NHS is likely to resemble the US capitalist healthcare industry. The US system will be examined for comparative purposes, followed by an analysis of how far earlier reforms under Conservative and New Labour governments have moved the NHS in that direction. The implications of the White Paper proposals are analysed to determine the degree to which the NHS is destined to become a commodity-producing industry. The tentative conclusion is that while secondary care will be similar in many ways to the US hospital industry, state funding remains a barrier to complete transformation, and what is likely to emerge is a hybrid system in which competition, consolidation, and pressure on the workforce all increase.

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