Alain Enthoven argued that an internal market model would offer substantial improvements over the existing NHS structures, where referrals were not tied to payment.
The review produced policy ideas including creation of an internal market and GP fundholding. This formed the basis of the 'Working for patients' white paper.
The white paper proposed significant reforms to the NHS. It introduced a split between the bodies who provided care and those who purchased it, creating an internal market in the NHS.
Despite growing opposition to the government's NHS reform programme and Thatcher's resulting concerns, Kenneth Clarke, Secretary of State, refused to back down.
Legislation provided for the 'purchaser/provider split'. This marked the start of an internal market in the NHS and changes to local authorities' social care functions.
