Competitive Tendering in the NHS

Abstract

The introduction of mandatory competitive tendering in 1983 came as a blow to health service administrators, but not as a surprise. Since 1979, the NHS had played host to privatisation initiatives, attempts to improve management and efficiency, and an attack upon local autonomy. Prolonged industrial action by ancillary workers in 1982 had coincided with a major reorganisation which abolished area health authorities. Further change in the way the service was run looked imminent with the appointment of the Griffiths Inquiry, whose brief was to suggest improvements in NHS management practices. These and other events which preceded the introduction of the tendering initiative help to explain both the initial opposition with which health authorities greeted the policy and, paradoxically, their longer-term reluctance to fight it.