ABSTRACT
In this chapter, the authors provide answers for the following question: How can we achieve competitive purchasing, to enable every patient to have reliable access to good care? The answers highlight revealing challenges concerning consumer control, ‘personalisation’, the coordination of care, and appropriate provider responsiveness. The PGCA will be the consumer’s champion, the expert facilitator. The authors compare what the competing PGCAs could do and what the now monopoly primary care trusts do or do not do. The competing PGCA would exert all its management and leadership skills to achieve coordinated provision and care. The competing PGCA would ensure that good information was made available through conventional market pressures. The PGCA would market its services directly to potential members who were in control of their own health savings account as a mobile fund. The success of a PGCA in attracting willing members would in part turn on the access and improved services they can achieve from competing providers.
