La experiencia internacional en la privatizacion de los servicios sanitarios publicos. El case de servicios integrados en el Reino Unido

The use of market mechanisms in the NHS has long been associated with privatisation in the English National Health Service but there has been a marked shift in policy emphasis away from market competition towards ‘system integration’ since the 2012 Health and Social Care Act. This includes integration between the various parts of the health service and integration between the health care and social care sectors. The benefits of integration include greater patient satisfaction, improved access and improved quality of care but the approach to securing it in England has been riven with division and conflict. This chapter draws on documentary data to combine a critique of integrated care policies in the past five years in England, an investigation of their implications for the privatisation of clinical services and a contextual understanding of the broader international policy agenda. It argues that there are several ways in which integrated policies facilitate privatisation and applies Krachler and Greer’s 2015 privatisation framework to explore this further.