Reorganisation Of The Nhs

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‘working for patients’ and ‘caring for people’ (DoH, 1989a, 1989b), and these formed the basis of the NHS and Community Care Act 1990.
The main focus of the impact was the concept of the internal market. This essentially involved the separation of two of the main functions of the NHS, purchasing and providing. Purchasing is defined as the buying of health services to satisfy local needs and providing, is defined as the day to day business of delivering that care. The purchasing agencies are provided with a budget which reflects their defined population, from which they must identify health needs, plan ways to satisfy them while ensuring the quality of the service. When the purchaser identifies their requirements, they produce a contract with the providers, who in turn invoice the purchaser for the materials and services provided. This illustrates the ‘Quasi-market’ in operation, a Quasi-market being a market which seems to exist but ...

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(Flynn 1993).

Llewellyn (1993) described the introduction of an ‘internal’ or ‘Quasi-market’ in health and social care, as a reaction to and was practically enabled, by an expanding population. Her research that looked at two factors, which forced reform in the NHS, demographic trends and technological advancement. The first factor focused on the growing problem facing nation states in the developed world is that of an ageing population and hence a greater dependence on the NHS in future years. Between 1961 and 1990 the percentage of the UK population over sixty five increased by one third and the numbers aged eighty five and over, more than doubled ...

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