Retaining the purchaser provider separation has been the policy of successive governments. In line with its predecessors, this Government considers it the most effective means of developing efficient high quality care while providing value for money for the public purse. More specifically, it created a means of managing the health service in which providers of care were accountable to the public through contracts which specified the quality of care, and its cost in a much more transparent way than had previously been the case. In doing so, it also drove improvement in both the quantity and quality of what the health service was providing.<\/p>
<\/p>
However, there are two distinct reasons why it has often been difficult to quantify the relative costs and benefits of the internal market. First, it is difficult to estimate the cost of what would have happened without it \u2013 in other words what would have been the case had such accountability not been in place. Second, there have been differing models for implementing the internal market over at least two decades (total purchasing pilots, general practitioner fundholding and practice-based commissioning).<\/p>
<\/p>
The impact assessment for the Health and Social Care Act 20121<\/sup> looked at the broad cost and benefits of continuing a separate commissioning function as an advocate for patients and the taxpayer, separate from the more autonomous provider side.<\/p> <\/p> Notes:<\/em><\/p> 1<\/sup>www.gov.uk/government/uploads/system/uploads/attachment_data/file/215819/dh_129916.pdf<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/2000", "label" : {"_value" : "Biography information for Earl Howe"}
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, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty's Government what assessment they have made of the costs and benefits of the internal market in the National Health Service over the last 20 years.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
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], "uin" : "HL1025"}
, {"_about" : "http://data.parliament.uk/resources/77292", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/77292/answer", "answerText" : {"_value" : " The Department does not hold the precise information requested. However, the Department has published guidance, entitled The Health and Care System Explained<\/em>, on organisations that are involved in the delivery of health services since the implementation of the Health and Social Care Act (2012). Based on that guidance, it is estimated that there are 16 national bodies and 224 local bodies that do not directly provide health services to patients within the system.<\/p> <\/p> By contrast, there are approximately 33,000 bodies in England that do provide NHS services directly to patients, including NHS trusts, NHS foundation trusts, general practices, dental practices, opticians and community pharmacies.<\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/2000", "label" : {"_value" : "Biography information for Earl Howe"}
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, "answeringMemberPrinted" : {"_value" : "Earl Howe"}
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, "date" : {"_value" : "2014-07-10", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "NHS"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
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], "questionText" : "To ask Her Majesty\u2019s Government how many legal entities exist within the National Health Service which do not directly deal with patients.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/4289", "label" : {"_value" : "Biography information for Baroness Manzoor"}
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, "tablingMemberPrinted" : [{"_value" : "Baroness Manzoor"}
], "uin" : "HL1026"}
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