Glennerster H, (1998)

‘Competition and Quality in Health Care: the UK Experience’

International Journal for Quality in Health Care, 10(5), pp. 403-410.

• Survey of the empirical literature on competition in the NHS.
• Reviews all references relating to district-based purchasing, and GP fundholding and commissioning.

Key findings:

• Evidence suggests little overall change for good or bad resulting from reforms.
• The changes that occurred had an impact on speed of treatment, patient convenience and choice. Benefits were reaped in particular by the more competitive agents - the family doctors or GPs.
• Medical quality was largely unaffected.
• Overall evidence supports the hypothesis that there were some efficiency gains by removing the virtual monopoly of NHS hospitals. This was done most effectively by GPs who had an interest in seeing their patients treated quickly and well.

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