Who owns and operates healthcare providers and does it matter

In explaining his economic reforms and the introduction of private ownership, Deng Xiao Ping famously said ‘It doesn't matter whether the cat is black or white as long as it catches mice’. Is there any reason to assume that this does not apply to the provision of healthcare? Although the government's policy to bring in independent sector providers in hospital, community and primary care sectors is in line with policy in many other countries, it has led to some heated debate1 and adverse reactions from those who see this as the first stage in breaking up the NHS.2 This paper reviews the history of the debate and the evidence that is available about whether ownership matters.