The East Anglian RHA undertook the ‘Rubber Windmill’ simulation of an internal market for the NHS in 1990

The ‘Rubber Windmill’ was an exercise commissioned by the East Anglian Regional Health Authority to simulate and ‘test to destruction’ an internal market for the NHS. Towards the end of the exercise, the simulated system ‘collapsed’ under the weight of conflicting financial and competitive pressures, leading some to suggest that any internal market would require some level of ‘management’ to be successful. Overall, the exercise was seen as an excellent learning experience (and has been repeated on a number of occasions since). 


Prime Minister: Margaret Thatcher

Health Minister: Kenneth Clarke