The use of markets in the health service: The NHS reforms and managed competition

John Appleby Manager of the Central Policy Unit, National Association of Health Authorities and Trusts, Birmingham

Ray Robinson Fellow at the King's Fund Institute

Wendy Ranade Senior Lecturer, Department of Economics and Government, Newcastle Polytechnic

Val Little Chief Policy Analyst at the West Midlands RHA

Judith Salter Research Officer, Managed Competition Project, NAHAT

In the two years since the publication of ‘Working for Patients’ the internal market has been reinterpreted as ‘managed’ competition. Policy conflicts have not been fully resolved and uncertainty still exists. Managed competition goes ‘live’ on 1 April 1991: it is too late for pilots; monitoring implementation is now essential.

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