Competition is a perennial policy prescription for reducing cost and improving quality. However, critics worry that competition may undermine socioeconomic equity in health care. In projects funded by the ESRC, MRC and NIHR SDO programme, researchers at CHE have examined this empirical hypothesis by exploiting two “natural experiments” in the English NHS. First, the Thatcher/Major “internal market” reforms in the 1990s introduced by a Conservative administration, and second, the Blair/Brown NHS reforms in the 2000s introduced by a Labour administration. We used comprehensive national data on hospital utilisation by all NHS patients, comparing use of services in more and less deprived small areas. In both cases, we found that competition had little or no effect on equity in the use of hospital services.
For further details see http://www.york.ac.uk/che/news/archive-2014/che-research-papers-66-67/