An empirical analysis of the purchaser-provider relationship in the NHS internal market

Introduces the relationship marketing paradigm as a means of analysing the purchaser-provider relationship within the NHS internal market. This focus is justified in the context of the limitations of orthodox economic analysis. The research evidence is based upon a national survey of all NHS trust hospitals in England. The survey consisted of key questions relating to the process of relationship building strategies employed by NHS hospital trusts. In particular, emphasis was given to non-price competitive behaviour, i.e. the extent to which health care contracts were augmented or customized by providers. An empirical analysis is presented, identifying those factors driving such non-price competitive behaviour, based upon a LOGIT model. The results suggest the hypotheses tested are consistent with the evidence from our survey. Finally, the model is used to make some tentative predictions regarding the future of the purchaser-provider relationship within the reformed NHS.