A decade of outsourcing in health and social care in England

What was it meant to achieve

Bibliographic Data

ID11196921
AuthorsAnders Malthe Bach-Mortensen (0000-0001-7804-7958, Department of Social Policy and Intervention University of Oxford Oxford UK, corresponding author), Benjamin Goodair (0000-0003-2619-7895, Department of Social Policy and Intervention University of Oxford Oxford UK), Christine Corlet Walker (0000-0002-5933-7586, Centre for the Understanding of Sustainable Prosperity University of Surrey Guildford UK)
Year2024
Volume58
Issue6
Pages938-959
Publication date2024-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Policy and Administration (JOURNAL)
Journal identifiersISSN: 0144-5596 • E-ISSN: 1467-9515
PublisherWiley (PUBLISHER • GB)
DOI10.1111/spol.13036
PMID39391370
OpenAlexW4398217225
LanguageEN
Citations received5
References cited43

The increased private provision of publicly funded health and social care over the last 75 years has been one of the most contentious topics in UK public policy. In the last decades, health and social care policies in England have consistently promoted the outsourcing of public services to private for‐profit and non‐profit companies with the assumption that private sector involvement will reduce costs and improve service quality and access. However, it is not clear why outsourcing often fails to improve quality of care, and which of the underlying assumptions behind marketising care are not supported by research. This article provides an analysis of key policy and regulatory documents preceding or accompanying outsourcing policies in England (e.g., policy document relating to the 2012 and 2022 Health and Social Care Acts and the 2014 Care Act), and peer‐reviewed research on the impact of outsourcing within the NHS, adult's social care, and children's social care. We find that more regulation and market oversight appear to be associated with less poor outcomes and slower growth of for‐profit provision. However, evidence on the NHS suggests that marketisation does not seem to achieve the intended objectives of outsourcing, even when accompanied with heavy regulation and oversight. Our analysis suggests that there is little evidence to show that the profit motive can be successfully tamed by public commissioners. This article concludes with how policymakers should address, or readdress, the underlying assumptions behind the outsourcing of care services

Business · Economic growth · Economics · Health care · Outsourcing · Political science · Public economics · Public relations · Employment and Welfare Studies · Healthcare innovation and challenges · Healthcare Systems and Challenges · Marketing · Public Administration

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