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Contracts in the English NHS: Market levers and social embeddedness.
- Source :
- Health Sociology Review; Sep2011, Vol. 20 Issue 3, p321-337, 17p
- Publication Year :
- 2011
-
Abstract
- 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. 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. 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- RISK management in business
GOVERNMENT agencies
CONTRACTING out
COOPERATIVENESS
DECENTRALIZATION in management
LABOR incentives
MEDICAL databases
INFORMATION storage & retrieval systems
INTERVIEWING
RESEARCH methodology
NATIONAL health services
MEETINGS
PAY for performance
NEGOTIATION
ORGANIZATIONAL change
EVALUATION of organizational effectiveness
RESEARCH funding
QUALITATIVE research
ORGANIZATIONAL structure
THEORY
SECONDARY analysis
SOCIAL context
INSTITUTIONAL cooperation
ECONOMIC competition
Subjects
Details
- Language :
- English
- ISSN :
- 14461242
- Volume :
- 20
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Health Sociology Review
- Publication Type :
- Academic Journal
- Accession number :
- 74387094
- Full Text :
- https://doi.org/10.5172/hesr.2011.20.3.321