Internal Markets, Management by Targets, and Quasi-Markets: An Analysis of Health Care Reforms in the English NHS

Kristian Niemietz

Economic Affairs, 2015, vol. 35, issue 1, 93-108

Abstract: There have been two major attempts to introduce market mechanisms into England's National Health Service: the ‘internal market’ reform project of the 1990s, and the ‘quasi-market’ of the 2000s. Despite their similarities, the former attempt was on balance unsuccessful while the latter succeeded. This article examines and compares the outcomes of the two periods, analysing the reasons for their relative successes and failures. It goes on to highlight options for future reforms that would build on those achievements.

Date: 2015
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