Earlier studies indicate that the purchaser-provider split
in practice not live up to the ideal of competition and contractual management (Walsh 1995, Hughes et al.
In Finland the purchaser-provider split
has aimed at the improvement of health care efficiency and mechanisms with which the state tries to direct the implementation of the model in practice.
The National Health Service (NHS) has undergone many changes in its 45-year history including in April 1991, the introduction of the purchaser-provider split
, and the creation of an internal market for health services within the NHS.
Of course, the authors are American, and their book is largely derived from the American context in which the purchaser-provider split
has a venerable tradition.
include both hospital and community care) and this has always been a challenge in the NHS with its purchaser-provider split
Many savings can be gained by changing the ways we do things, like getting rid of the market place in health care, the so-called purchaser-provider split
The British Medical Association (BMA), while supporting some of the reforms, has also raised concerns over those proposals that could widen the purchaser-provider split
and increase the commercialisation of the NHS.
We do want to get rid of the purchaser-provider split
and we will have to look at ways to undertake that.
The update fails to discuss the new opportunities to purchase much more appropriate, accessible and sensitive services from the private and voluntary sectors given by the purchaser-provider split
in health and social services organization.
In relation to commissioning, administration and management costs went up from 6% before the purchaser-provider split
to 14% of total NHS expenditure, with the Department of Health causing concern for not providing 'clear and consistent data on transaction costs,' and with a suspicion of it being less than candid (p15).
A report by the Health Select Committee on commissioning has concluded that the NHS purchaser-provider split
may need to be abolished if figures on the cost of commissioning do not suggest that it is economical.
The truth is that attempts to create purchaser-provider splits
in public services have been endemic in the UK since the 1980s.