Chapter Seven: Creeping Privatisation? Examining Procurement Choices in the ‘New’ NHS in England

This chapter focuses on the introduction and implementation of the Health and Social Care Act (UK Legislation 2012) in England which reignited the debate about the extent to which the government-funded National Health Service (NHS) is being privatised and/or marketised. It analyses past health service policy developments as they relate to the role of the private health sector, providing a broad sociological and policy context for the most recent legislation and considering the extent to which these represent a radical shift or an incremental policy change. The chapter draws on an ethnographic study of decision-making by the newly created Clinical Commissioning Groups about the extent to which privatisation is taking place. The central argument is that while there has been a considerable change in the commissioning apparatus, private providers have not yet made inroads into the NHS. The chapter concludes by discussing the possible long-term implications of the legislation, considering the extent to which it may have indirectly, rather than directly, encouraged a drift towards privatisation.