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Technocracy, the market and the governance of England's National Health Service

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  • David P. Horton
  • Gary Lynch‐Wood

Abstract

England's National Health Service, the fifth largest employer in the world, has become heavily influenced by expert authority and the market economy, which has had implications for accountability and the receptiveness of health decisions to stakeholder needs. One response has been the introduction of a range of regulatory provisions designed to facilitate effective governance and stakeholder engagement. These provisions are scrutinized using three conceptual devices: core accountability, social reporting and social learning. These devices have significant implications, as they enable technical experts to form closed communities, communicate among themselves mainly about economic and financial matters, and make decisions that aid the market without meaningful recourse to citizens. While technical experts are necessary to help manage complex areas, current arrangements reinforce an existing gap between economic and democratic values through hardened technocratic approaches to health care governance.

Suggested Citation

  • David P. Horton & Gary Lynch‐Wood, 2020. "Technocracy, the market and the governance of England's National Health Service," Regulation & Governance, John Wiley & Sons, vol. 14(2), pages 295-315, April.
    • Handle: RePEc:wly:reggov:v:14:y:2020:i:2:p:295-315
    DOI: 10.1111/rego.12208
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    References listed on IDEAS

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    2. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    3. Sanderson, Marie & Allen, Pauline & Osipovic, Dorota, 2017. "The regulation of competition in the National Health Service (NHS): what difference has the Health and Social Care Act 2012 made?," Health Economics, Policy and Law, Cambridge University Press, vol. 12(1), pages 1-19, January.
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