The Role of the State in the British Healthcare System — Between Marketization and Statism

Abstract

Since the phenomenon of globalization hit the field of comparative social policy in the 1990s, scholars have discussed whether the changing context of modern nation states has had an impact upon welfare state development, and if so, how welfare states or single welfare schemes have adapted to this new environment (Pierson 2001b). Taking this debate as a starting point, this chapter addresses the changes in the British healthcare system — the core scheme of the British welfare state. In doing so, it focuses particularly on the question of how the role of the state in the British healthcare system has changed since the early 1970s, the time when the oil price shocks and their repercussions caused severe disruptions to economic growth in all European states, including Great Britain.

… we are anxious to ensure that this is the start for opening up the whole of the NHS supply system so that we end up with a situation where the state is the enabler, it is the regulator, but it is not always the provider.

(Tony Blair 2003 as quoted in Pollock 2004: 69)