The Purchaser‐provider Split in Principle and Practice: Experiences from Sweden

Abstract

In the public sector, market‐inspired organisation, control and accounting, along with business‐like relationships between organisational units, usually goes under the name of New Public Management (NPM). One organisational form associated with NPM is the purchaser‐provider split. The model was first used in Sweden by county councils at the end of the 1980s. It was considered to be an effective and democratic method for managing Swedish health care. Over the past few years, researchers in many countries have begun doubting the model's suitability and whether it has really been used in the way that was intended. However, the model is still popular in the Swedish health care sector. This article presents the effects of the purchaser‐provider split found in Swedish studies. These effects are compared to the anticipated effects when the model was launched, and the effects of the purchaser‐provider split in Britain. The aim of this article is to explore the effects of the purchaser‐provider split in practice.