In pursuit of an improving national health service

This report explains why previous attempts at introducing market-based reforms in the NHS failed.


Published: 01/05/1999

ISBN: 1902089375

Download the report [PDF 388.4KB]

Disappointingly little progress was made with poor hospitals being allowed to continue to operate, health authorities denied the freedom to purchase selectively and every minor change became a major political issue.

Today, some 15 years later, quality related information in the NHS remains virtually non-existent, and fear of political cross-fire continues to frustrate much need progress in developing a model for the NHS which would allow it to succeed in the 21st century. Professor Enthoven recommends re-inventing the internal market in a way which allows the NHS to achieve modernisation through consumer choice, competition and substantially more resources and lists the key elements necessary to ensure the success of a new model.

Suggested citation

Enthoven A (1999) In pursuit of an improving national health service. Research report. Nuffield Trust.