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Why Did the British Government Promote Public-Private Partnerships in the NHS Through the Concordat of 2000?

By: Peter Walker

Abstract: Labour came into power in 1997 indicating its opposition towards the use of the private sector in caring for NHS patients, but by October 2000 the government had signed a Concordat with the private sector to encourage such practice. New research based on content-analysis of newspaper articles, Prime Minister's Questions (PMQs), and selected Institute for Public Policy Research (IPPR) and government publications suggests that this policy shift occurred for reasons that are consistent with John Kingdon's theory of agenda-setting whereby 'problem', 'political' and 'policy' streams must coincide for policy change to occur. Four 'problems' are identified through a thorough analysis of three national newspapers ? 'capacity', 'finance', 'staffing' and 'care standards' ? with the perceived severity of these problems, especially for 'capacity' and 'finance', peaking between January and October 2000. The 'political stream' peaked in 2000 with the government coming under pressure to address 'finance' and 'capacity' issues in the NHS. The rise of Public Private Partnerships ? specifically 'publicly-purchased privately-provided health care' - in the 'policy stream' was reflected by the changing tone of IPPR publications between 1997 and 2000, and was influenced by the replacement of Dobson with Milburn as Secretary of State for Health, and the government's increased frustration with existing solutions to NHS capacity constraints. A 'policy window' was created by the coinciding of these streams as a result of which the Concordat between the Department of Health and the independent healthcare sector was signed, cementing the long-term use of the private sector in the provision of NHS care onto the health policy agenda.

Home Papers Policy Agendas Project Other Projects Books Position Papers		Papers Why Did the British Government Promote Public-Private Partnerships in the NHS Through the Concordat of 2000? By: Peter Walker Abstract: Labour came into power in 1997 indicating its opposition towards the use of the private sector in caring for NHS patients, but by October 2000 the government had signed a Concordat with the private sector to encourage such practice. New research based on content-analysis of newspaper articles, Prime Minister's Questions (PMQs), and selected Institute for Public Policy Research (IPPR) and government publications suggests that this policy shift occurred for reasons that are consistent with John Kingdon's theory of agenda-setting whereby 'problem', 'political' and 'policy' streams must coincide for policy change to occur. Four 'problems' are identified through a thorough analysis of three national newspapers ? 'capacity', 'finance', 'staffing' and 'care standards' ? with the perceived severity of these problems, especially for 'capacity' and 'finance', peaking between January and October 2000. The 'political stream' peaked in 2000 with the government coming under pressure to address 'finance' and 'capacity' issues in the NHS. The rise of Public Private Partnerships ? specifically 'publicly-purchased privately-provided health care' - in the 'policy stream' was reflected by the changing tone of IPPR publications between 1997 and 2000, and was influenced by the replacement of Dobson with Milburn as Secretary of State for Health, and the government's increased frustration with existing solutions to NHS capacity constraints. A 'policy window' was created by the coinciding of these streams as a result of which the Concordat between the Department of Health and the independent healthcare sector was signed, cementing the long-term use of the private sector in the provision of NHS care onto the health policy agenda.

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