Competition in health care: what does it mean for nurse managers?

The English Government has launched a series of radical market-orientated reforms whose goal is to get the National Health Service to 'act smarter' by undermining with public-private competition the monopoly power of providers, in particular 'inflexible' National Health Service hospitals and medical practitioners. The failure of nurses and managers to remedy well established problems in the delivery of health care, for instance variations in medical practice, medical errors and the continued absence of measures of patient outcome or clinical success, together with slow changes in waiting time performance, has persuaded Mr Blair to use the market to induce more rapid change. Whether this unevaluated and radical social experiment will succeed is impossible to forecast precisely. However, it will oblige nurse managers to have increased recourse to the evidence base and the need to translate such material in improved practice. It will also oblige them to be able to access and use in their day-to-day management improved administrative data about practice activity and patient outcomes.