After approximately 30 years, and following a decisive move towards integrated
care systems, competition reforms in English healthcare seem
to be rejected, even though the underlying relationship between the public
healthcare system and private healthcare market remains. This paper
explains how competition in English healthcare has developed to involve
the Competition and Markets Authority and a sectoral regulator (NHS Improvement), and how general UK merger control and the prohibition on anticompetitive agreements have been applied. Current legislative proposals
call for a substantial refocusing of competition authority involvement and
removal of the regulator’s competition powers. These proposals are developing
against a backdrop of closer cooperation between public and private
healthcare providers in response to COVID-19. This paper concludes by
suggesting that the current opportunity to rethink how competition works
in English healthcare is a welcome development.