I am researching how increasing private sector involvement in the NHS will affect patient care. The arguments made by policy makers and their advisers is that introducing patient choice, where “the money follows the patient”, will motivate staff to improve their services (Department of Health, 2010; Le Grand, 2009). Many critics talk about profit as a corrupting force which has potential to “crowd out” the altruistic motivations of NHS workforce (Pollock, 2004; Leys & Player, 2011).
I propose that the current discussion is based on ideological principles which make claims about human nature or inner psychological motives associated with “profit”. Arguments against “the privatisation of the NHS” also fail to recognise the intimate relationship between the private sector and the NHS that has existed since its creation, assuming that the NHS as a state run service can be isolated from the capitalist system which the state itself enables. Rather, I intend to take a more empirical approach to understanding how different forms of exchange within the NHS have agency within patient care. Using the example of a hip replacement, I will carry out observations and interviews to understand the involvement of different motivations around sites of decision and exchange.
Dr Simon Cohn: http://www.lshtm.ac.uk/aboutus/people/cohn.simon
Professor Nicholas Mays: http://www.lshtm.ac.uk/aboutus/people/mays.nicholas