17.) NHS the internal market experiment Flashcards
What are the discrepancies in funding in the NHS?
Higher SES patients tend to receive more care than lower SES patients.
What led the government at the time to make changes to the NHS?
The concerns over growing costs
What are the suggested new models?
Split the NHS budget between all the GPs based on list size, patient needs etc. Then the GPs will buy services from referrals
What is the new model which was taken up for some time?
Surplus funds made by GPs were retained and re-invested, patients register with their GP of choice, can be referred anyway. Introduce scheme gradually. Simulates an ‘internal’ market. Gives consumer choice and provides incentive for efficiency.
What was the result of GPs becoming fund holders?
Became more cost efficient, less prescriptions given, shorter waiting times, often referred patients as ‘emergencies’ when they were not, expensive patients excluded, GPs inflated spending before joining scheme.
What are the problems of competition in healthcare?
Information asymmetry, barriers to entry, collusion. Reduction in quality, conflict with equity, tendency of market to re-concentrate
