Understanding public services and care markets

The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.

2005

We welcome comments about PSSRU publications. We would particularly appreciate being told of any problems experienced with electronic versions as otherwise we may remain unaware of them.

2005

We welcome comments about PSSRU publications. We would particularly appreciate being told of any problems experienced with electronic versions as otherwise we may remain unaware of them.

2005

Much of social care of older people now takes place in the context of a market. As a result the welfare of many people is fundamentally dependent on the success of that market in terms of both availability of services and quality of care. This paper considers the functioning of that market to date and the challenges it is likely to face in the future. Social care is unlike most other markets in terms of the nature of the product, characteristics of consumers, the relationship between prices, fees and charges, and the dominant role and influence of the public sector. This paper starts by describing and defining what we mean by social care and the context in which the markets have developed. The extent and nature of the market are then outlined in terms of levels, distribution and types funding, the development of the commissioning role by public bodies and the impact on the market of changes in the regulatory system. The role of and involvement of service users as consumers in this m...

Health Affairs, 2002

Britain's Labour government has systematically dismantled the competitive underpinnings its predecessor government put in place, in favor of more central control. Are the reforms working? by Julian Le Grand PROLOGUE: The British National Health Service (NHS) is probably one of the most closely scrutinized health systems in the world. Following its inception after World War II, as a way to provide health security for Britain's war-weary population, the NHS has remained one of Britain's most revered institutions, despite its well-publicized shortcomings. Over the past several decades it has survived Conservative governments' waves of privatization, which transformed other venerable British institutions, such as British Rail, and not necessarily for the better. These governments did introduce market-oriented reforms that stopped short of full privatization. However, the most recent Labour government, headed by Tony Blair, has undertaken yet another revision of the NHS, this time to reintroduce the concept of collaboration, which some would argue has resulted in a return to central control. In this paper Julian Le Grand outlines the interaction among competition, collaboration, and central control, as the Blair government's reforms take effect. Although there have been some changes-and, importantly, some infusions of new funds-in the NHS, the jury is still out on whether these changes have truly improved matters. One stark indicator, waiting times for elective surgery and other procedures, has indeed improved, but a closer look reveals that even that situation is not as clear-cut as it might appear. Le Grand is the Richard Titmuss Professor of Social Policy at the London School of Economics. He is an honorary fellow of the Faculty of Public Health Medicine, a founding academician of the Academy of Learned Societies for the Social Sciences, and a senior associate of the Kings Fund. He holds a doctorate in economics from the University of Pennsylvania, where he was a Thouron Scholar. He has acted as an adviser to the World Bank, the European Commission, the World Health Organization,

2006

The Nuffield Trust is a charitable trust carrying out research and policy analysis on health services. Its focus is on the reform of health services to improve the efficiency, effectiveness, equity and responsiveness of care. For more information on our work programme, and to subscribe to our free e-newsletter, visit www.nuffieldtrust.org.uk Published by The Nuffield Trust,

2018

We investigate how other high-income countries have thought about and implemented changes to their funding systems for health and social care to better meet the challenges ahead. This paper is part of a broader project funded by the Health Foundation, which aims to identify a range of feasible options for the future funding of health and social care in the four countries of the UK, and assess the relative (un-)attractiveness of different funding approaches to the general public. The research reported here examines trends and innovations in health and social care funding in a selection of high-income countries. We focus on where the money to pay for care comes from, not on how it is then spent. Drawing on a review of the literature and interviews with 30 key informants in a range of high-income countries, we explore current thinking on the options for funding health care and social care. Our aim is to add to the evidence base and improve the quality of the debate, rather than make re...

2018

Health Foundation working papers Health Foundation working papers are outputs from our funded and in-house research activity. The papers share findings from research and are subject to peer review prior to publication. They are not published in the same form elsewhere, but the findings may be included in peer-reviewed journal articles. Content may also be subject to change following further research and analysis.

About HSMC HSMC has been one of the leading UK centres for research, personal and organisational development in health care for nearly 40 years. Commissioning of healthcare and provision of healthcare outside hospitals have become specific areas of expertise in recent years, underpinned by a continuing commitment to issues of quality improvement and public and patient engagement. This reputation has also extended to adult social care, with a growing track record in inter-agency commissioning and provision of health and social care services. HSMC has also developed a national reputation for both organisational and leadership development across all health settings. For further information visit: www.hsmc.bham.ac.uk

International Journal of Management Concepts and Philosophy, 2010

In recent decades, there has been a growing shift towards the use of markets and quasi-markets in healthcare provision and an increasing managerialism in the context of major increases in expenditure. The paper offers some comparative data on these trends and poses some basic questions as to whose interests have been served by this and whether this has been the best way to improve patient provision and health outcomes.