New Labour competition reforms did not increase health inequalities

The report, by the York Centre for Health Economics, found no evidence that the reforms of the Blair-Brown years had changed health inequalities.

Meanwhile, academics at the London School of Economics have published a separate review of evidence warning that more research was needed to understand how recent competition reforms had affected the quality of hospital care.

Dr Richard Cookson, project lead on the York study, said: “Our findings echo similar results from previous research into the Conservative ‘internal market’ reforms of the NHS in the 1990s, all of which points to little change in socio-economic equity in healthcare over the past two decades. 

“Neither Conservative nor Labour attempts to introduce competition into the NHS appear to have had any measurable effect on socio-economic equity in healthcare.”

The York researchers said critics of the Labour reforms had warned that increased competition would undermine equality, by “encouraging NHS hospitals to ‘cherry-pick’ profitable patients and avoid socio-economically disadvantaged patients who are less healthy and more difficult to treat”.

However, analysing data on all NHS hospital patients in England, they found “no substantial change in socio-economic patterns of hospital use from 2001-02 to 2008-09, either overall or for a basket of common hospital services including hip, cataract, heart and gastroscopy procedures”. 

But the review by LSE professor Gwyn Bevan and research student Matthew Skellern, published by the British Medical Journal on Monday, concluded that the effect of increased patient choice on elective surgery outcomes remained an “open question”.

The study, which covered evidence both on the 1990s NHS “internal market” and on the New Labour reforms, said: “More research is required before conclusions can be drawn about the effect of recent reforms on hospital quality, let alone about the merits of Andrew Lansley’s proposals further to extend competition.”