Restructuring, Privatization and the Geography of Health Care Provision in England, 1983-1987

Substantial recent changes in the provision of both public and private health services in England are discussed and interpreted in the light of an analysis of contemporary Conservative politics as a 'two nations' political strategy. There are two principal implications of this for health care: attempts to restructure the character of health care delivery, and policies designed to effect a greater degree of privatization of health care. After summarizing the 'two nations' view of Conservative political strategy, the paper then considers spatial implications of restructuring within the NHS, focusing on spatial resource allocation between and within Regional Health Authorities (RHAs) and on the responses by health authorities to alterations in the resources available to them. Aspects of privatization are then discussed, notably the expansion of acute hospital care, private nursing homes for the elderly, and efforts to raise funds from non-Exchequer sources by health authorities. In the conclusion the notions of restructuring and privatization are evaluated.