New development: Commercialization of the English National Health Service: a necessity in times of financial austerity?

Abstract

This article examines income received by National Health Service (NHS) providers from non-NHS sources. In 2015–2016, it amounted to 9.1% of their revenue. In the English NHS, there is an increasing reliance on non-NHS income to provide revenue for NHS organizations, due in part to government’s austere financial plans. This article is the first comprehensive analysis of these financial data for all English organizations. It provides new evidence in the ongoing debate about the nature and values of public service organisations and the role of commercial imperatives. IMPACT: The commercialization strategies of public organizations affects the nature and content of the public services they deliver. It also has ethical implications for staff who enact these strategies. This article examines the commercial income of health organizations in England following a relaxation of rules allowing them to increase their commercial income, for example from car parking, land sales, renting out retail space on hospital grounds, partnerships with pharmaceutical businesses, clinical trials and providing clinical services to private patients and international medical tourists. The authors raise important questions about the extent of commercial imperatives in the English NHS.