Free to choose?
Marty Gaynor, Carol Propper, Stephan Seiler 13 January 2013
Greater choice and competition in healthcare is a popular reform model. This column discusses recent research suggesting that once restrictions on choice in the UK’s NHS were lifted, patients receiving cardiac surgery became more responsive to the quality of their care. This saved lives and gave hospitals a greater incentive to improve quality.
A central plank of the NHS reforms implemented by the UK Labour government of the 2000s was the introduction of patient choice. For the first time in the history of the NHS it was mandated that patients should have a say in the choice of hospital when being referred for an elective treatment. Rather than relying entirely on their general practitioner (GP), patients were now offered a set of five hospitals to choose from.
health, NHS, patient choice
Can pay regulation kill? Evidence from English hospital trusts
Carol Propper, John Van Reenen 30 January 2008
Centrally determined pay for public sector workers like NHS nurses acts as a maximum wage in some labour markets. Here is a summary of a new study arguing that the resulting hiring difficulties are causing patient deaths.
Economists have long warned of the unintended consequences of labour market regulation (Botero et al. 2004). Some things that seem fair – like paying people the same wage for doing the same job regardless of where they work – may turn out to be foul in practice. Although people often worry about the minimum wage pricing people out of jobs, a regulation that may impose a maximum wage and price people out of jobs has received little attention.
Health economics Labour markets
maximum wage, NHS, patient deaths, temporary staff