Debate Kathy Evans, Chief Executive Public Service Markets Aren’t Working for the Public Good… or as markets In November 1989, Kenneth Clarke, then Secretary of State for Health, published a White Paper, ‘Working for patients (NHS reforms)’, which proposed to introduce a split between purchasers and providers of care, GP-fundholders and a state-financed internal market, ‘in order to drive service efficiency’ in the National Health Service. Less than a year later, the creation of an ‘internal market’ in Britain’s largest public service had passed into law. A new public policy idea had been born, one that discarded previous economic orthodoxy about the fundamental difference between public and private sectors within a ‘mixed economy’. Read the full chapter by Kathy for Kittens Are Evil: Little Heresies in Public Policy This extract from Kittens Are Evil contains just Chapter 2: Public Service Markets Aren't Working for the Public Good... or as markets, by Kathy Evans, Chief Executive of Children England. It is offered free of charge to help disseminate the important ideas it contains. If you would like to read more, please consider buying or recommending Kittens Are Evil. It's available from the publishers at www.triarchypress.net/kittens or you can order it from any good bookseller or you can buy it on amazon.