Do Quasi-markets Evolve? Institutional Analysis and the NHS

David Hughes, Lesley Griffiths and Jean V McHale

Cambridge Journal of Economics, 1997, vol. 21, issue 2, 259-76

Abstract: Institutional analysis offers a promising opportunity for theoretical cross-fertilization between economics and sociology. Neo-institutional economics argues that organizations gravitate towards common forms of economic organization (markets, hierarchies, or hybrid forms) primarily to minimize transaction costs, the new institutionalism in sociology contends that convergence may also depend on mimetic, normative, and coercive processes affecting 'organizational fields.' This paper examines organizational change in the NHS, focusing on areas of convergence and divergence in the contracting policies adopted by Welsh health authorities and trusts. Some versions of institutional analysis portray change as an evolutionary process driven primarily by efficiency considerations. The authors suggest that the development of NHS contracting policy is characterized by periodic strategic and administrative shifts which cast doubt on the evolutionary model and resemble the coercive institutional processes described by the sociological institutionalists. Copyright 1997 by Oxford University Press.

Date: 1997
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