Malak Ikbal Nasri Gr 04

Q: what are the most important changes that Thatcher introduced in the
health sector ?

A:

Thatcher’s Reforms in the Health Sector

Thatcher aimed to base her reforms on four main principles: a commitment to free
enterprise, British nationalism, a plan to increase the state's efficiency, and a belief in
traditional Victorian values, essentially hard work and civic responsibility. By the end of
the 1980s, the Conservative government had recast the patient-consumer relationship in
health care, shifting the emphasis away from collective needs and toward individual rights
within increasingly marketized services. Thatcher believed that the health service lacked
"too much sensitivity to patients' preferences and convenience," so she implemented a
series of policies aimed at putting patients' needs first. The three main reforms that brought
gradual change were the Griffith report of 1983, National Health Service and Community
Care Act 1990, and the introduction of purchaser/provider healthcare split.

First , the Griffiths Management Enquiry of 1983 recommended for the NHS to
become more business-like, and managers be introduced into the National Health Service
(NHS) to solicit consumer feedback on services and "ensure the best service possible for the
patient." . Applying the NHS to a particular form of managerialism, led directly to the
introduction of a quasi-market in health care centered on competition and choice. Yet , it was
not that perfect as the report emphasized and valued the local service manager, it resulted in a
political conflict between the autonomy of frontline public health sector professionals and
managers who governed them.

Second, the National Health Service and Community Care Act of 1990 led to the
creation of the internal market and its gradual implementation over the 90s. It separated the
acts of purchasing and providing services (the purchaser/provider split). Potential buyers
would obtain funding directly from the Department of Health, and providers would
compete for funds and services through commercial contracts. The internal market was
divided into stages, with two types of buyers: District Health Authorities (DHAs) and
General Practitioners (GPs). Hospitals and community health services became independent
providers identified as trusts, with funding derived from contracts with DHAs. It did
 Malak Ikbal Nasri Gr 04

introduce competition among the system's organizations and resulted in an important

organizational paradigm shift.

To recap, Margaret's first steps toward the liberalization of the health sector were
managerialism and the implementation of a purchaser/provider healthcare split. Before ,
Thatcher saw public services as bloated, inefficient, unreliable to user preferences, and
frequently underperforming. She hoped to give more to the British because health is a vital
sector, both morally and economically. So, during her term as Prime Minister, she ensured
that this sector was subjected to privatization and competition for better services.