New providers in UK health care

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Abstract
What effect will more competition have on the NHS? Over the past 5-10 years the European airline market has been completely transformed by the introduction of new players. Through a combination of adding capacity and radically changing traditional ways of working, Ryanair and Easyjet have effectively challenged the status quo among the traditional incumbents (British Airways, Alitalia, Air France, etc) and created a whole new approach to air travel across Europe. Can the same transformation happen in health care? The current UK government hopes so. Since its election to office in 1997, the government has set itself an ambitious strategy to substantially improve health care. The strategy has three key planks—improvement of quality, expansion of capacity, and introduction of new incentives (in particular customer choice1) to drive through radical changes (box). This article explores how the expansion of capacity through opening up health care to new providers, combined with increasing consumer choice, will change the way in which health care is provided and used. The NHS Plan focused on increasing capacity and put at its heart key targets for the reduction of waiting lists and waiting times for planned elective care.2 By 2005, no patient will have to wait more than six months for a routine operation, and by 2008, waiting times will be less than three months. ![][1] Changes in health care could bring substantial benefits to patients Credit: NW LONDON NHS TRUST #### Mechanisms for implementing three key components of NHS strategy Improving quality #### Increasing capacity #### Creating incentives for change Increased capacity will be achieved partly by expanding existing NHS services but also by purchasing services from non-NHS organisations—so called plurality of provision.3 The … [1]: /embed/graphic-1.gif