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SOME RECENT EVIDENCE ON NHS COMPETITION:

http://www.nber.org/papers/w18574
Martin Gaynor, Carol Propper, Stephan Seiler
NBER Working Paper No. 18574, November 2012

ABSTRACT: The impacts of choice in public services are controversial. We exploit a reform in the English National Health Service to assess the impact of relaxing constraints on patient choice.[...] Patients became more responsive to clinical quality. Sicker patients and better informed patients were more affected. [...] We find increased demand responsiveness led to a significant reduction in mortality and an increase in patient welfare. The elasticity of demand faced by hospitals increased post-reform, giving hospitals potentially large incentives to improve their quality of care and find suggestive evidence that hospitals responded strongly to the enhanced incentives due to increased demand elasticity. The results suggests greater choice can enhance quality.