Contact: Mr. David Whynes
Tel. (0115) 951 5463
Fax. (0115) 951 4159
EMail david.whynes@nottingham.ac.uk
The 1990 National Health Service and Community Care Act set in train the most far-reaching reforms of the health service in this country since its inception in 1948. The reform involves a shift from a directly state-managed service to an "internal market" in which GPs and others will be provided with budgets to purchase services from a range of providers to meet the needs of their patients. The fund-holding GP has a pivotal role in the new system. This research examines the process whereby GP practices take the decision to become fund-holders, purchasing services on behalf of their patients, or choose to remain in their traditional role of self-employed contractors to the NHS.
The research will incorporate three approaches. First, a small group of GPs in the Trent region will be interviewed in order to explore the background to their decisions about fund-holding and their more general attitudes to business and to the role of the family doctor in the NHS. Secondly, a more detailed experimental study of the attitudes to entrepreneurship of some 240 of the GPs in the region will be carried out. The third element is a national survey of a random sample of some 2,000 GPs. This will build on the two earlier phases of the work to provide nationally representative material on the relationship between attitudes to entrepreneurship, ideas about the NHS and actual behaviour in terms of the decision to become a fund-holder or not.
The research will be of considerable practical relevance to policy-makers in the area of health care. It will also have implications for understanding of the part that values play in sustaining entrepreneurship and of the cultural changes associated with current reforms of the welfare state.
DAVID WHYNES is Reader in Health Economics at the University of Nottingham and has published a large number of papers on the development of health care.
CHRISTINE ENNEW is Professor in Marketing at the University of Nottingham and has written extensively on entrepreneurship and on matters affecting business.
OTHER RESEARCHERS:
Teresa Feighan, University of Nottingham.
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