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...The background productivity challenge uk healthcare sector characterised by growth in expenditure over time long period tends to outstrip gdp as other countries many estimates of are low imperial college business school english national health service from nhs economics hec apr doi http onlinelibrary wiley com full fig greater competition is one way address this england has been a pioneer use pro market reforms formerly heavily centralised and regulated systems several european oecd have also had major lessons experience outline brief overview evaluation impact on choice outcomes reflections for future...