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Has competition in the NHS increased health care inequalities?

Posted on 10 October 2011

Increased competition in the NHS has not harmed deprived neighbourhoods, according to new research from the Centre for Health Economics (CHE), University of York.

Using data on all NHS hospital patients in England, CHE researchers examined whether increased competition led to increased socio-economic inequality of access to health care.

Project lead Dr Richard Cookson said:

“Our findings echo similar results from previous research into the Conservative ‘internal market’ reforms of the NHS in the 1990s, all of which points to little change in socio-economic equity in health care over the past two decades.  Neither Conservative nor Labour attempts to introduce competition into the NHS appear to have had any measurable effect on socio-economic equity in health care.”
Commenting in the Financial Times, Julian Le Grand, Richard Titmuss professor of social policy at the London School of Economics and a former policy adviser to then-prime minister Tony Blair, said: “This is a very important result. It shows that one of the most frequent criticisms of patient choice and hospital competition in the NHS - that it would disadvantage the less well-off - is quite misplaced.”

The two latest CHE research papers report the findings of this research.
CHERP66  Does hospital competition harm equity? Evidence from the English NHS
CHERP67  Measuring change in health care equity using small area administrative data – evidence from the English NHS 2001-8 

 Press Release 66 & 67 (PDF , 52kb)  

An article by Richard Cookson was published on Friday 14 October in the Guardian Healthcare Network.