The role of the third sector in public health service provision: evidence from 25,338 heterogeneous procurement datasets

We examine the role of nonprofits within publicly funded healthcare which runs parallel to private provision in a ‘two-tier’ system through a unique Big Data pipeline. Scraping tens of thousands of heterogeneous transaction datasets across a commissioning hierarchy, the processed dataset contains over £445Bn worth of transactions in 1.9m+ rows of clean data, spanning 2012–2020. We utilize this dataset to test a range of hypotheses related to the introduction of the Health and Social Care Act of 2012. The proportion of contracts placed with nonprofit organizations is relatively low, with limited evidence as to whether the Act increased the involvement of third sector organizations in line with NHS ‘marketization’. We analyse the pattern of procurement by corporate category, the field of service delivery (International Classification of Nonprofit Organizations and Standard Industrial Classification codes), and ‘expense area’ to show the unique array of services which voluntary organizations supply. We also analyse the pattern of commissioning across entity class and size distributions of registered charities. We conclude with a consideration of high-value Community Interest Companies, and discuss potential further areas of research within a healthcare context which such government transaction data makes possible.