CLASSIFICATION PROBLEMS AND THE DIVIDING LINE BETWEEN GOVERNMENT AND THE MARKET: AN EXAMINATION OF NHS FOUNDATION TRUST CLASSIFICATION IN THE UK

ABSTRACT: In this paper we argue that national accounting categories provide an inadequate basis for evaluating differences between public and private sector services. This is because accounting categories rely on economic concepts such as market price but do not take account of substantive public policy goals such as universality. The argument has important consequences for the structures and systems of delivery especially where nonprofit providers and social enterprise models are substituted for public bodies formerly integrated into the government's delivery system. Using an example taken from the UK's National Health Service, we show that the mechanisms for ensuring universality through redistribution are not sufficiently taken into account for classification purposes.