Within the remit of the Health and Social Care Act the provision of healthcare services by private providers is set to endure and grow. I am not interested in the ideological arguments that surround this. What I have been considering is the battleground and potential inequalities that seem counter intuitive to the benefit of introducing market forces. Looking at existing market strategies, the closest model I can find that represents the current commissioning structure is franchising.

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There are a myriad of examples of inconsistent thinking when it comes to the NHS and working patterns. I would like to focus on the pre-assessment service for anaesthesia, before you have your surgery as an example relevant to me.

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It has indeed been a baptism of fire. Within 2 hours of going live NHS Survival received harsh criticism. We were called a "Jeremy-Hunt bashing group", a "self-interest group and our aims are ridiculous". The one which hurt though is that we "don't represent patients".

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