Author Description

The author takes a detailed look at the scope for improving patient services offered through an internal market. The potential for more efficient use of beds and staff time; The possibility of lower costs resulting from more specialisation; the effects of competition on NHS wages and salaries; and the implications for patient choice are all subjected to critical examination. Moreover, the danger of greater competition leading to more unequal access to health care is also highlighted. The study concludes that the potential merits of an internal market need to be demonstrated rather thab asserted. There is unsufficient evidence to warrant the wholesale adoption of the idea throughout the NHS in a single move. But there is sufficient evidence to support the case for experiment involving trade between districts within a single trial region.