Analysing the 'new' British National Health Service

The British National Health Service (NHS) has seen a proliferation of confusing and sometimes conflicting labels in recent years. It has been claimed that during the Conservative Government's period of office the 'classic' NHS was 'restructured' and then turned into the 'new' NHS. The New Labour Government of 1997 has claimed that it will deliver a 'new' NHS. If all these claims are correct, it should be possible to identify four distinct periods, with three clear 'breaks of slope' with significant changes in important indices on moving from one label to another. This paper attempts to look behind these labels by critically examining what has changed in the NHS since 1979. In simple terms, what has been 'restructured'? What is new about the 'new' NHS? Why are these changes important? It is concluded that while the NHS has certainly undergone significant changes in the past 20 years or so, the appearance of a 'new' NHS may be premature as in many areas it is possible to see the marks of continuity as well as change, and policy impact is characterised by greater incrementalism than policy rhetoric.