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.
These trusts assumed responsibility for the ownership and management of hospitals, previously managed or provided by regional, district or special health authorities.
The government launched the Citizen's Charter to redefine the relationship between citizens and public service, seeking to set out the rights and entitlements of patients.
In 1992, the Conservative government introduced private finance initiatives (PFI). The main objective was to harness the private sector's efficiency, management and commercial expertise.
A total purchasing pilot (TPP) scheme was launched, allowing GPs in a locality to purchase all hospital and community health services for their patients.
The Health Committee published a report on purchasing, endorsing a separation between strategy and operational delivery as an approach to priority setting.
