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Incentives and health policy: primary and secondary care in the British National Health Service

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  • Hausman, Dan
  • Le Grand, Julian

Abstract

This paper argues that issues concerning incentives and motivation are crucial to recent reforms to the British National Health Service. It examines how the incentive structure of General Practitioners with respect to the interface between primary and secondary care changed with the introduction of GP fundholding, and how it might change further with the new Primary Care Groups. It concludes that the effectiveness of the internal incentive structure of the new groups will depend on the location of power within the PCGs, and that the external incentives involving the possibility of heavy central monitoring may affect the behaviour and motivation of GPs in potentially harmful ways.

Suggested Citation

  • Hausman, Dan & Le Grand, Julian, 1999. "Incentives and health policy: primary and secondary care in the British National Health Service," Social Science & Medicine, Elsevier, vol. 49(10), pages 1299-1307, November.
    • Handle: RePEc:eee:socmed:v:49:y:1999:i:10:p:1299-1307
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    Citations

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    Cited by:

    1. Gary Higgs & Myles Gould, 2000. "Health-Care Commissioning, the Modern NHS, and Geographical Information Systems," Environment and Planning A, , vol. 32(11), pages 1905-1908, November.
    2. Nibene H. Somé & Rose Anne Devlin & Nirav Mehta & Gregory S. Zaric & Sisira Sarma, 2020. "Stirring the pot: Switching from blended fee‐for‐service to blended capitation models of physician remuneration," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1435-1455, November.
    3. Grytten, Jostein & Sorensen, Rune, 2007. "Primary physician services--List size and primary physicians' service production," Journal of Health Economics, Elsevier, vol. 26(4), pages 721-741, July.
    4. Aoife Brick & Anne Nolan & Jacqueline O’Reilly & Samantha Smith, 2012. "Conflicting Financial Incentives in the Irish Health-Care System," The Economic and Social Review, Economic and Social Studies, vol. 43(2), pages 273-301.
    5. Sorensen, Rune J. & Grytten, Jostein, 2003. "Service production and contract choice in primary physician services," Health Policy, Elsevier, vol. 66(1), pages 73-93, October.
    6. Rudkjøbing, Andreas & Vrangbaek, Karsten & Birk, Hans Okkels & Andersen, John Sahl & Krasnik, Allan, 2015. "Evaluation of a policy to strengthen case management and quality of diabetes care in general practice in Denmark," Health Policy, Elsevier, vol. 119(8), pages 1023-1030.
    7. Grytten, Jostein & Sorensen, Rune, 2001. "Type of contract and supplier-induced demand for primary physicians in Norway," Journal of Health Economics, Elsevier, vol. 20(3), pages 379-393, May.
    8. Jostein Grytten & Rune Sørensen, 2000. "Competition and dental services," Health Economics, John Wiley & Sons, Ltd., vol. 9(5), pages 447-461, July.
    9. McDonnell, Thérèse & Nicholson, Emma & Barrett, Michael & Bury, Gerard & Collins, Claire & Cummins, Fergal & Deasy, Conor & Denny, Kevin & De Brún, Aoife & Hensey, Conor & McAuliffe, Eilish, 2021. "Policy of free GP care for children under 6 years: The impact on emergency department attendance," Social Science & Medicine, Elsevier, vol. 279(C).

    More about this item

    Keywords

    Incentives Motivation Doctors GPs;

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