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From competition to co‐operation: new economic relationships in the National Health Service

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  • Maria Goddard
  • Russell Mannion

Abstract

The Labour government has outlined its plans to ‘replace’ the competitive internal market with a more collaborative system based on partnership. Agreement amongst purchasers and providers is to be based on co‐operation rather than competition. Longer term agreements covering periods of 3–5 years are to replace annual contracts within this new environment. The aim of this paper is to explore the potential economic implications of these policy changes by drawing on the economics of co‐operation and the transaction costs approach to longer term contracting. Issues surrounding the role of trust in contractual relationships are explored and the relevance of experience and evidence from non‐health care sectors is considered in the context of the NHS. It is concluded that both theory and empirical evidence suggest that co‐operation and trust can play a central role in the efficient organisation of contractual arrangements in circumstances similar to those under which the NHS operates. However, we warn against the expectation that the policy changes will produce automatically the scale of benefits predicted by the Labour government, especially as they will have to find a way of extracting reasonable performance from providers under a system of collaboration and long term agreements. They may find they need to tread a fine line between competition and co‐operation in order to reap the benefits of both. © 1998 John Wiley & Sons, Ltd.

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  • Maria Goddard & Russell Mannion, 1998. "From competition to co‐operation: new economic relationships in the National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 105-119, March.
    • Handle: RePEc:wly:hlthec:v:7:y:1998:i:2:p:105-119
    DOI: 10.1002/(SICI)1099-1050(199803)7:2<105::AID-HEC333>3.0.CO;2-K
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    1. Baumol, William J, 1982. "Contestable Markets: An Uprising in the Theory of Industry Structure," American Economic Review, American Economic Association, vol. 72(1), pages 1-15, March.
    2. Shelanski, Howard A & Klein, Peter G, 1995. "Empirical Research in Transaction Cost Economics: A Review and Assessment," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 11(2), pages 335-361, October.
    3. Crocker, Keith J & Lyon, Thomas P, 1994. "What do Facilitating Practices Facilitate? An Empirical Investigation of Most-Favored-Nation Clauses in Natural Gas Contracts," Journal of Law and Economics, University of Chicago Press, vol. 37(2), pages 297-322, October.
    4. Arrighetti, Alessandro & Bachmann, Reinhard & Deakin, Simon, 1997. "Contract Law, Social Norms and Inter-firm Cooperation," Cambridge Journal of Economics, Cambridge Political Economy Society, vol. 21(2), pages 171-195, March.
    5. Demsetz, Harold, 1988. "The Theory of the Firm Revisited," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 4(1), pages 141-161, Spring.
    6. Hubbard, R Glenn & Weiner, Robert J, 1991. "Efficient Contracting and Market Power: Evidence from the U.S. Natural Gas Industry," Journal of Law and Economics, University of Chicago Press, vol. 34(1), pages 25-67, April.
    7. Joskow, Paul L, 1985. "Vertical Integration and Long-term Contracts: The Case of Coal-burning Electric Generating Plants," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 1(1), pages 33-80, Spring.
    8. Besanko, David & Lyon, Thomas P., 1993. "Equilibrium incentives for most-favored customer clauses in an oligopolistic industry," International Journal of Industrial Organization, Elsevier, vol. 11(3), pages 347-367, September.
    9. Keith J. Crocker & Scott E. Masten, 1988. "Mitigating Contractual Hazards: Unilateral Options and Contract Length," RAND Journal of Economics, The RAND Corporation, vol. 19(3), pages 327-343, Autumn.
    10. Burchell, Brendan & Wilkinson, Frank, 1997. "Trust, Business Relationships and the Contractual Environment," Cambridge Journal of Economics, Cambridge Political Economy Society, vol. 21(2), pages 217-237, March.
    11. Schwartz, Marius, 1986. "The Nature and Scope of Contestability Theory," Oxford Economic Papers, Oxford University Press, vol. 38(0), pages 37-57, Suppl. No.
    12. Kirk Monteverde & David J. Teece, 1982. "Supplier Switching Costs and Vertical Integration in the Automobile Industry," Bell Journal of Economics, The RAND Corporation, vol. 13(1), pages 206-213, Spring.
    13. McMaster, Robert, 1995. "Competitive Tendering in UK Health and Local Authorities: What Happens to the Quality of Services?," Scottish Journal of Political Economy, Scottish Economic Society, vol. 42(4), pages 409-427, November.
    14. Pirrong, Stephen Craig, 1993. "Contracting Practices in Bulk Shipping Markets: A Transactions Cost Explanation," Journal of Law and Economics, University of Chicago Press, vol. 36(2), pages 937-976, October.
    15. Maria Goddard & Russell Mannion & Brian Ferguson, 1997. "Contracting in the UK NHS: purpose, process and policy," Working Papers 156chedp, Centre for Health Economics, University of York.
    16. Crocker, Keith J & Masten, Scott E, 1991. "Pretia ex Machina? Prices and Process in Long-Term Contracts," Journal of Law and Economics, University of Chicago Press, vol. 34(1), pages 69-99, April.
    17. Klein, Benjamin & Crawford, Robert G & Alchian, Armen A, 1978. "Vertical Integration, Appropriable Rents, and the Competitive Contracting Process," Journal of Law and Economics, University of Chicago Press, vol. 21(2), pages 297-326, October.
    18. Joskow, Paul L, 1987. "Contract Duration and Relationship-Specific Investments: Empirical Evidence from Coal Markets," American Economic Review, American Economic Association, vol. 77(1), pages 168-185, March.
    19. Williamson, Oliver E, 1983. "Credible Commitments: Using Hostages to Support Exchange," American Economic Review, American Economic Association, vol. 73(4), pages 519-540, September.
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    Cited by:

    1. Huw Talfryn Oakley Davies & Russell Mannion, 1999. "Clinical governance: striking a balance between checking and trusting," Working Papers 165chedp, Centre for Health Economics, University of York.
    2. Maria Goddard & Russell Mannion & Peter Smith, 2000. "Enhancing performance in health care: a theoretical perspective on agency and the role of information," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 95-107, March.
    3. Sonali Das & Ming‐Hui Chen & Nicholas Warren & Michael Hodgson, 2011. "Do associations between employee self‐reported organizational assessments and attitudinal outcomes change over time? An analysis of four Veterans Health Administration surveys using structural equatio," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1507-1522, December.
    4. Russell Mannion & Andrew Street, 2009. "Managing activity and expenditure in the new NHS market," Public Money & Management, Taylor & Francis Journals, vol. 29(1), pages 27-34, January.
    5. Brian Ferguson, 1998. "Shaping up to improve health: the strategic leadership role of the new Health Authority," Working Papers 162chedp, Centre for Health Economics, University of York.
    6. Natasha Palmer & Anne Mills, 2003. "Classical versus relational approaches to understanding controls on a contract with independent GPs in South Africa," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1005-1020, December.
    7. van den Broek, Judith & Boselie, Paul & Paauwe, Jaap, 2018. "Cooperative innovation through a talent management pool: A qualitative study on coopetition in healthcare," European Management Journal, Elsevier, vol. 36(1), pages 135-144.
    8. Guinness, Lorna, 2011. "What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?," Social Science & Medicine, Elsevier, vol. 72(12), pages 1939-1947, June.

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