The policy and politics of healthcare corporatisation: The case of the English NHS

Rod Sheaff*, Pauline Allen, Mark Exworthy, Russell Mannion

*Corresponding author for this work

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Abstract

Rationale: Few accounts of healthcare corporatisation examine the effects of the 2008 financial crisis. New Politics of the Welfare State (NPWS) theories recognise the relevance of crises but give more attention to programmatic than systemic (structural) retrenchment, and little to healthcare corporatisation. Objective: To examine what changes the 2008 financial crisis produced in the pattern of healthcare corporatisation, and the implications for NPWS theories. Methods: Using administrative data from the English NHS during 1995–2019 we formulated a multi-dimensional index of corporatisation, tested its validity, and used it to analyse longitudinally how the financial crisis affected the balance between the responsibilization of management and re-commodification (introduction of market-like practices) in provider corporatisation. Results: The financial crisis influenced NHS corporatisation through the fiscal austerity with which governments responded. The re-commodification of NHS providers stalled but not the responsibilization of NHS managers. Conclusions: The corporatisation of NHS providers faltered after the financial crisis. These findings corroborate parts of NPWS theory but also reveal scope for further elaborating its accounts of systemic retrenchment in health systems.

Original languageEnglish
Article number116505
JournalSocial Science and Medicine
Volume342
Early online date21 Dec 2023
DOIs
Publication statusPublished - Feb 2024

ASJC Scopus subject areas

  • Health (social science)
  • History and Philosophy of Science

Keywords

  • Austerity
  • Commodification
  • Corporatisation
  • Financial crisis
  • Fiscal
  • New politics of the welfare state
  • NHS
  • Responsibilization
  • Policy
  • Economic Recession
  • State Medicine
  • Humans
  • Delivery of Health Care
  • Politics

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