The Implications of Privatisation in the English National Health Service for Healthcare Labour Supply and Productivity

Waiting times in the English National Health Service (NHS) have seen a steady increase in the past decade, and the Covid-19 pandemic accelerated the number of patients waiting for investigations and treatment reaching 7.75 million in August 2023.

NHS England's current plan to recover elective and cancer care after the Covid-19 pandemic aims to expand the use of the private healthcare sector to increase the capacity of care available to NHS patients, widen patient choice, and meet government targets for elective care.

NHS trusts already make use of bank and agency temporary workforce, outsourcing services to the private sector, which delivers a greater share of overall care since the pandemic, and employing private providers to insource services on trust premises.

This government policy-driven privatisation takes place on a background of severe health workforce shortages and increasing demand for health workers to address the health needs of an ageing population. In the public sector, NHS England operates as a monopsonist in an environment of fiscal and resource constraints.

Yet, there is limited evidence about the implications of privatising publicly funded NHS services for the health workforce in England amidst existing health workforce shortages.