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The regulation of competition and procurement in the National Health Service 2015–2018: enduring hierarchical control and the limits of juridification

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  • Osipovič, Dorota
  • Allen, Pauline
  • Sanderson, Marie
  • Moran, Valerie
  • Checkland, Kath

Abstract

Since 1990, market mechanisms have occurred in the predominantly hierarchical National Health Service (NHS). The Health and Social Care Act 2012 led to concerns that market principles had been irrevocably embedded in the NHS and that the regulators would acquire unwarranted power compared with politicians (known as ‘juridification’). To assess this concern, we analysed regulatory activity in the period from 2015 to 2018. We explored how economic regulation of the NHS had changed in light of the policy turn back to hierarchy in 2014 and the changes in the legislative framework under Public Contracts Regulations 2015. We found the continuing dominance of hierarchical modes of control was reflected in the relative dominance and behaviour of the sector economic regulator. But there had also been a limited degree of juridification involving the courts. Generally, the regulatory decisions were consistent with the 2014 policy shift away from market principles and with the enduring role of hierarchy in the NHS, but the existing legislative regime did allow the incursion of pro market regulatory decision making, and instances of such decisions were identified.

Suggested Citation

  • Osipovič, Dorota & Allen, Pauline & Sanderson, Marie & Moran, Valerie & Checkland, Kath, 2020. "The regulation of competition and procurement in the National Health Service 2015–2018: enduring hierarchical control and the limits of juridification," Health Economics, Policy and Law, Cambridge University Press, vol. 15(3), pages 308-324, July.
  • Handle: RePEc:cup:hecopl:v:15:y:2020:i:3:p:308-324_2
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 6th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-06 11:00:00

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