Policy implications of contracting out care: the case of total hip replacements

Research performed by Nicholl and his colleagues at Sheffield University has shown that private health care provision in the United Kingdom trends to be concentrated among certain activities, in particular those activities falling under the broad heading of elective surgery. Consequently although total private provision is dwarfed by the aggregate provision of health care under the national health service, whether measured in bed availability, expenditure or throughput, the private sector is found to be a much more significant supplier of certain procedures. In this paper the findings of the Sheffield "team" are considered along with the policy issues that they give rise to for one particular activity, total hip replacement (THRs).