Limits of the Market, Constraints of the State: the public good and the NHS

In this essay, published in January 2005, Secretary of State for Health Dr John Reid MP sets out the case for extending patient choice within the NHS.

He tackled two misconceptions head-on: the belief that ‘choice’ is a value solely for those on the ideological right and the idea that choice is only meaningful within markets where the chooser’s own private money is brought to bear.

Dr Reid argues that choice in health care ought to be welcomed by those with social democrat instincts, since it empowers individual patients irrespective of their personal wealth and holds out the promise of more responsive, higher quality services for all users. This new model of service organisation signals a welcome shift away from the old structure of central state planning and provision. But it need not, Dr Reid argues, entail the introduction of markets into the structure of the NHS.

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