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Welfare Reform on the Web (March 2007): National Health Service - primary and community care

Born in the USA

S. Ward

Public Finance, Feb. 2nd - 8th 2007, p.20-23

US-style case management programmes are increasingly being introduced into the NHS in order to save money by reducing emergency hospital admissions of patients with chronic illnesses. The involvement of US health firms in the NHS is being encouraged by the Department of Health and will increase over time. However these companies are not getting involved in health care delivery in the UK out of altruism, but in search of profits.

Closed policy networks, broken chains of communication, and the stories behind “entrepreneurial policy”: the case of NHS Local Improvement Finance Trust (NHS LIFT)

R. Aldred

Critical Social Policy, vol.27, 2007, p.139-151

NHS Local Improvement Finance Trust (LIFT) comprises over fifty public-private partnership companies formed to modernise primary care premises. This entrepreneurial approach to the delivery of public services generally is strongly supported and promoted by government, to the extent that any opposing voices are unheard. The author presents a case study comparing the entrepreneurial rhetoric used to justify LIFT with the experience of NHS managers and clinicians on the ground, showing how dissenting voices remain unheard outside private interviews and meetings. The study suggests that closed networks of politicians and senior managers are promoting private-public partnerships, and excluding those who will actually have to make the policies work.

Critics claim money is the force behind demand management

D. Carlisle

Health Service Journal, vol.117, Feb. 22nd 2007, p.14-15

In order to balance their books, primary care trusts have introduced a range of demand management schemes, including unilaterally issuing lists of routine procedures that they will not fund without prior approval, setting up referral management centres, halting consultant-to-consultant referrals, and attempting to place primary care staff in accident and emergency departments.

So where are the alternative providers in primary care?

N. Walsh, J. Maybin and R.Q. Lewis

British Journal of Health Care Management, vol. 13, 2007, p. 43-46

Alternative provider medical services (APMS) contracts introduced in 2004 offer primary care trusts (PCTs) the opportunity to commission services from both the independent sector and members of the NHS “family”. PCTs are beginning to use APMS contracts to commission services to increase provision in under-doctored areas and to meet the needs of new populations. However, the volume of alternative providers in primary care remains small, and the use of APMS is limited. GP-owned businesses continue to exercise a virtual monopoly over provision.

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