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Planning, Markets and Hospitals

Improving access to hospital services has been a goal of public policy in Britain for over seventy years, but the means by which this goal is to be attained have changed significantly over time. Drawing substantially on original research, Planning, Markets and Hospitals represents a systematic attempt to access the strengths and weaknesses of different forms of planning and coordination of hospital development. The book discusses the successes and failures of the mixed economy of health care in the inter-war period, including a consideration of the nature of public-private partnerships. It pivots around, and reevaluates, the national Hospital Plan of 1962, and questions the rather uncritical reception given to this plan. Problems in implementing this plan led to growing frustrations, which contributed to a reassessment of planning and the promotion of greater competition in health policy. Ultimately the outcome was the market-based reforms of 1991. While these appeared to pit hospital against hospital in competing for patients, substantial elements of planning remained in place. The book concludes with an assessment of contradictory elements of Labour's policies, in which substantial spending coexists with a growing role for the private sector. Throughout, attention is given to key themes of regulation and governance, of the appropriate balance between planning and markets, and the question of the ways governments have sought to regulate and extend access to health care. It reinterprets previous histories of hospital policy and questions whether current policies will reconcile competing goals of equity and choice.
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Table of Contents

1. Planning Markets and Welfare: Debates about Hospital Policy and the Welfare State 2. Legacies, Donations and Municipal Priorities: The Evolution of the British Hospital Services Prior to 1948 3. Regionalism: A Positive or Negative Consensus? 4. Wartime Hospital Policy: Attractions and Limitations of Public-Private Partnerships 5. The Absence of a Capital Programme, 1948-59 6. Explaining and Reappraising the 1962 Hospital Plan 7. From 'Plan' to 'Programme', 1962-73 8. A Programme Without Policy? Hospital Developments 1973-91 9. Hospitals After the 1991 Reforms: Markets, Hierarchies or Networks? 10. Conclusions


This book clearly became far more newsworthy as it was written. Mohan is a geographer but this book is really about the history and politics of hospital construction. There is a focus on England and especially the North East, from which there are frequent detailed examples. Martin Rathfelder Healthmatters

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