Which “Internal Market”?

There are two potential types of “internal markets”. In Type I, the patient is treated only by “contracted” providers while in Type II, he/she is free to choose a provider. The rhetoric of Working for Patients is Type II while the practice is Type I. Type I market with its contracting concept is a pernicious version of the line relationship that existed in the past between health authorities and provider units. The ethos of the NHS is best suited to the Type II market which is similar to the market that operates in higher education, another public service.