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Reframing Social Citizenship$
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Peter Taylor-Gooby

Print publication date: 2008

Print ISBN-13: 9780199546701

Published to Oxford Scholarship Online: January 2009

DOI: 10.1093/acprof:oso/9780199546701.001.0001

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The NHS Reforms as a Response to First‐Order Challenges

The NHS Reforms as a Response to First‐Order Challenges

Chapter:
(p.130) 8 The NHS Reforms as a Response to First‐Order Challenges
Source:
Reframing Social Citizenship
Author(s):

Peter Taylor‐Gooby

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199546701.003.0008

Chapters 8 and 9 seek to anchor the analysis of the previous three chapters in a concrete policy context by considering the impact of recent reforms in the field of UK health care. The NHS is the flagship of the British welfare state and at the heart of public sector reform. A New Public Management system (quasi-markets, strict targets and strong incentives for managers, regulation of quality from the centre, and better information for users) has transformed the service. Comparisons of changes in provision over time and between regions of the UK indicate considerable improvement at a time of increasing pressure on health care. However, these gains rest on substantially increased resources and there has been little improvement in cost-efficiency and productivity. Improvements for disadvantaged minorities are much less impressive. Public attitudes and responses display considerable disquiet with the reform programme, particularly in relation to confidence and trust.

Keywords:   NHS, reform, New Public Management, quasi-market, incentives, productivity, improvement, attitudes, confidence, trust

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