Competition policy in Bismarck and Beveridge healthcare systems: Competition law, merger control and the relationship between competition authority and sectoral regulator in Dutch and English healthcare

Guy, Mary (2016) Competition policy in Bismarck and Beveridge healthcare systems: Competition law, merger control and the relationship between competition authority and sectoral regulator in Dutch and English healthcare. Doctoral thesis, University of East Anglia.

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Abstract

This thesis examines two competition provisions (sections 72 and 79) of the Health and Social Care Act 2012 by reference to the Dutch experience of applying identical or very similar laws (relating to competition law and merger control, respectively) and establishing equivalent institutional arrangements following wide-ranging reforms in 2006. Therefore the overarching legal framework – which also applies to other liberalised sectors – belies differences between the Dutch health insurance system and the English taxation-funded NHS which have implications for the ways in which competition can develop.

Thus both countries have been confronted with the apparently inconsistent applicability of EU competition law to healthcare providers, but not purchasers. Although applicability of general merger control has attracted less ambiguity, both countries have developed a range of amendments which can collectively be termed “healthcare-specific” merger control. The creation of healthcare regulators and their relationship with competition authorities with regard to applying competition law is also examined, since this has proved more controversial than that regarding merger control.

The discussions of the thesis are underpinned by three frameworks developed from health law and competition law literature and juxtapose conceptions from each. Firstly, a ‘healthcare structure’ comprising levels relating to state intervention, purchasers and providers. Secondly, a ‘continuum’ reflecting the move away from healthcare provision as a public service overseen exclusively by government to a market-based system overseen by a competition authority. Thirdly, ‘competition-centric’ and ‘healthcare-centric’ approaches are juxtaposed to reflect perceptions that healthcare may be different to other sectors thus merit special treatment.

Overall, the thesis contributes to both health and competition law literature by offering a comprehensive analysis of competition in English healthcare as well as by its comparative approach. It further marks a contribution in terms of legal literature to a subject area more typically associated with economics and political science.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Social Sciences > School of Law
Depositing User:	James Tweddle
Date Deposited:	12 Sep 2019 14:01
Last Modified:	12 Sep 2019 14:01
URI:	https://ueaeprints.uea.ac.uk/id/eprint/72138
DOI:

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