STRUCTURAL CHANGE IN THE NHS AND GP UTILIZATION IN ENGLAND UNDER NEW LABOUR, 1997–2003

In this article we compare the pattern of service utilization in the period preceding the health‐care reforms introduced by New Labour with service utilization following the refoms. Data from the 1997 and 2003 waves of the British Household Panel Survey are used to estimate a series of utilization functions. These show that GP utilization overall fell, for women more than men and for the sick more than others. The results suggest that GPs responded to the changing context the reforms created but there are different interpretations of that response. They support the contention that GPs devoted greater attention to preventative services post‐reform than had previously been the case. They are also consistent with the contention that GPs responded less directly to the needs of their patients, either because they became more sophisticated in interpreting those needs or conscious of the increased opportunity costs of responding to them.