Economics and economists in the National Health Service: Lessons from a doomed world

Abstract: Economists believe that employing economics thinking and analysis will improve decision making in the NHS about important issues.  It is arguable that the post-White Paper world will need even more economics, both during the current transition period and when the new arrangements are in place.  But how should we ensure that economics does make an impact, and is it best to pursue it from within or outside of the NHS?  Drawing on pre-White paper experiences, I will suggest that economics has had some impact on the way that the NHS makes decisions at a local level and there is much enthusiasm for economic analysis, but understanding and proper analysis of issues both remain at a very limited level.  I will argue that this is less a problem of engagement by the NHS and more of a failure by academic and other health economists to communicate effectively with those in the NHS and to offer useful support to them.  It will be unfortunate if we do not learn from the old, doomed, NHS world, which was making progress with this issue, to make sure that the new one is less doomed.