Quasi‐markets in British Health Policy: A Longue Durée Perspective

Abstract

Abstract Quasi‐markets in health care are generally associated with the period 1991–7 in the later years of office of the British Conservative Party. This paper aims to place such claims in a wider framework by exploring definitions of and conditions of success for quasi‐markets over a longer timescale, beginning in the 1930s and ending with the current New Labour government. It suggests a typology of quasi‐markets based on hard versus soft, direct versus indirect and internal versus external forms. It applies these categories and the conditions for success for quasi‐markets to seven historical periods. Both the typologies and the conditions for success of quasi‐markets varied over time, defying a simple linear development, suggesting a more nuanced historical narrative than simple continuity or discontinuity accounts of recent developments provide. Covering such a large topic over a long sweep of time, with the absence of clear evidence for much of the period, necessarily means that verdicts tend to be impressionistic. However, even at this level, the tentative conclusions provide important contextual elements in the debate on quasi‐markets.