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Privatizing the English National Health Service: an irregular verb?
1University of Birmingham.
Abstract:
This article explores different stakeholder perspectives of "privatization" in the English National Health Service (NHS). Much of the academic literature makes empirical claims about privatization on the basis of absent or shaky definitions of the term, resulting in much of the debate on this issue largely being a "non-debate," where opponents talk past rather than to each other. We aim to throw light on privatization by applying the lens of the "three-dimensional" approach (ownership, finance, and regulation) of the mixed economy of welfare to the views of key voices within these debates. These stakeholder perspectives are political (parliamentary debates), public (opinion polls), clinical provider (British Medical Association and Royal College of Nursing), and campaigning groups. We argue that in terms of grammar, "privatize" seems to be an irregular verb: I want more private-sector involvement; you wish to privatize the NHS. The term privatization is multidimensional, and definitions and operationalizations of the term are often implicit, unclear, and conflicting, resulting in differing accounts of the occurrence, chronology, and degree of privatization in the NHS. Stakeholders have divergent interests, and they use "privatization" as a way to express them, resulting in a Tower of Babel.
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