Privatising the supply of health care: evidence, please?

Abstract

Is there a rationale underpinning NHS decision-making about the provision of health care, or are the policy trends merely the product of gurus staggering around in search of enlightenment? A combination of unjustified optimism about the effects of new technologies, in particular day case surgery, combined with a frenzy of Private Finance Initiative investments which shrank the bed stock (in part because of hopes about reductions in length of stay) has led to a large contraction in the bed stock of the NHS. Whilst there were 458,000 beds in 1980, there are only about 255,000 acute beds in the NHS now. in the 1987-97 decade, the available bed stock shrank by 34 per cent, and most NHS managers and successive Ministers did not realise what they were doing.