How Fair? Competition between Independent and NHS Providers to Supply Non-Emergency Hospital Care to NHS Patients in England

Abstract

Competition is firmly established as a tool of public policy in England and is being accorded a growing role within health care. Since 2002 competition has become an actively promoted tool of government health care policy in England, particularly for the provision of hospital care to publicly funded patients. Independent sector (IS) providers of hospital services have been encouraged to compete with the state owned National Health Service (NHS) providers.

This study focuses on competition between state owned and independent hospitals to provide care to publicly funded patients. Within the independent sector there are both not-for-profit and for-profit providers. Where this distinction affects the ‘fairness’ of competition with NHS providers it is highlighted below. But competition issues for the most part affect for-profits and not-for-profits similarly.