 Implementing market-based reforms in the English NHS: Bureaucratic coping strategies and social embeddednessLorelei Jones, Mark Exworthy and Francesca Frosini Health Policy, 2013, vol. 111, issue 1, 52-59 Abstract: This paper reports findings from an ethnographic study that explored how market-based policies were implemented in one local health economy in England. We identified a number of coping strategies employed by local agents in response to multiple, rapidly changing and often contradictory central policies. These included prioritising the most pressing concern, relabelling existing initiatives as new policy and using new policies as a lever to realise local objectives. These coping strategies diluted the impact of market-based reforms. The impact of market-based policies was also tempered by the persistence of local social relationships in the form of ‘sticky’ referral patterns and agreements between organisations not to compete. Where national market-based policies disrupted local relationships they produced unintended consequences by creating an adversarial environment that prevented collaboration. Keywords: Health care policy; Policy implementation; Markets; England (search for similar items in EconPapers) Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:111:y:2013:i:1:p:52-59 DOI: 10.1016/j.healthpol.2013.03.010 Access Statistics for this article Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput More articles in Health Policy from Elsevier |
Is your work missing from RePEc? Here is how to contribute.
Questions or problems? Check the EconPapers FAQ or send mail to .
EconPapers is hosted by the
School of Business at Örebro University.