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Contracts in the English NHS: Market levers and social embeddedness

David Hughes, Christina Petsoulas, Pauline Allen, Shane Doheny, Peter Vincent-Jones

Health Sociology Review, Volume: 20, Issue: 3, Pages: 321 - 337

Swansea University Author: David Hughes

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Abstract

<p>This paper draws parallels between the market trend in the English NHS and Polanyi's (1957) The Great Transformation: The political and economic origins of our time, Beacon Press: Boston (originally published in 1944 in the United States as The Great Transformation, Rinehart: and Co: N...

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Published in: Health Sociology Review
ISSN: 1446-1242
Published: 2011
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URI: https://cronfa.swan.ac.uk/Record/cronfa6777
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spelling 2011-10-01T00:00:00.0000000 v2 6777 2012-01-24 Contracts in the English NHS: Market levers and social embeddedness f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2012-01-24 FGMHL <p>This paper draws parallels between the market trend in the English NHS and Polanyi's (1957) The Great Transformation: The political and economic origins of our time, Beacon Press: Boston (originally published in 1944 in the United States as The Great Transformation, Rinehart: and Co: New York, and in 1945 in England as Origins of our time, Gollancz: London) account of how the rise of markets provokes a self-protective counter-reaction that tries to re-embed economic relations in social relations.</p><p>We report findings from a qualitative study of NHS contracting, which examines the recent move to harder-edged contracts with greater use of financial penalties and incentives. In practice, use of these techniques tended to be confined to nationally-mandated sections of the contract rather than emerging from local bilateral agreements, and when things went wrong the parties relied more on cooperative behaviour than on the provisions of the contract to find solutions.</p><p>Making the current contracting system work depended more on existing relational networks than on the incentive structures created by recent 'marketisation' initiatives, but the inability of the market to evolve as expected has encouraged policy makers to publish plans for further radical reforms.</p> Journal Article Health Sociology Review 20 3 321 337 1446-1242 31 12 2011 2011-12-31 10.5172/hesr.2011.20.3.321 <p><span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Hughes, D. Petsoulas, C. Allen, P. Doheny, S. and Vincent-Jones, P</span></p>Refereed journal article COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2011-10-01T00:00:00.0000000 2012-01-24T10:15:23.1730000 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health David Hughes 1 Christina Petsoulas 2 Pauline Allen 3 Shane Doheny 4 Peter Vincent-Jones 5
title Contracts in the English NHS: Market levers and social embeddedness
spellingShingle Contracts in the English NHS: Market levers and social embeddedness
David Hughes
title_short Contracts in the English NHS: Market levers and social embeddedness
title_full Contracts in the English NHS: Market levers and social embeddedness
title_fullStr Contracts in the English NHS: Market levers and social embeddedness
title_full_unstemmed Contracts in the English NHS: Market levers and social embeddedness
title_sort Contracts in the English NHS: Market levers and social embeddedness
author_id_str_mv f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author David Hughes
author2 David Hughes
Christina Petsoulas
Pauline Allen
Shane Doheny
Peter Vincent-Jones
format Journal article
container_title Health Sociology Review
container_volume 20
container_issue 3
container_start_page 321
publishDate 2011
institution Swansea University
issn 1446-1242
doi_str_mv 10.5172/hesr.2011.20.3.321
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description <p>This paper draws parallels between the market trend in the English NHS and Polanyi's (1957) The Great Transformation: The political and economic origins of our time, Beacon Press: Boston (originally published in 1944 in the United States as The Great Transformation, Rinehart: and Co: New York, and in 1945 in England as Origins of our time, Gollancz: London) account of how the rise of markets provokes a self-protective counter-reaction that tries to re-embed economic relations in social relations.</p><p>We report findings from a qualitative study of NHS contracting, which examines the recent move to harder-edged contracts with greater use of financial penalties and incentives. In practice, use of these techniques tended to be confined to nationally-mandated sections of the contract rather than emerging from local bilateral agreements, and when things went wrong the parties relied more on cooperative behaviour than on the provisions of the contract to find solutions.</p><p>Making the current contracting system work depended more on existing relational networks than on the incentive structures created by recent 'marketisation' initiatives, but the inability of the market to evolve as expected has encouraged policy makers to publish plans for further radical reforms.</p>
published_date 2011-12-31T03:08:21Z
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