Restructuring Health Care: The Social Geography of Public and Private Health Care under the British Conservative Government

Abstract

The 1979 election of the Conservative Government in Britain was not followed by the demolition of the welfare state. However, a variety of policy initiatives were introduced both to restructure National Health Service (NHS) expenditure, and to facilitate private provision of health services. This article considers the effects of such policies on the existing and future distribution of health care resources. A historical introduction discusses the main thrusts of conservative welfare policy. This is followed by an examination of the current financial situation of NHS authorities, at the regional and sub-regional scales; the political response to the 1983 manpower reductions is also considered. Events in the NHS are then contrasted with the deregulation of the private sector. The emergence and distribution of commercial acute hospitals are examined, as are other initiatives designed to transfer some of the financial burden of welfare provision away from the state. A concluding section compares and contrasts these developments and considers prospects for the future form of health care provision in Britain.