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


  • Hausman, Dan
  • Le Grand, Julian


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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    Cited by:

    1. 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.
    2. 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.
    3. 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.
    4. Jostein Grytten & Rune Sørensen, 2000. "Competition and dental services," Health Economics, John Wiley & Sons, Ltd., vol. 9(5), pages 447-461.
    5. Feng, Y. & Farrar, S. & Sutton, M. & May, A., 2011. "The Effect of an Increase in the Rate of Payment on General Practitioner's Intrinsic and Extrinsic Motivation," Research Papers 000175, Office of Health Economics.
    6. 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.
    7. 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.

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