City Research Online

Commodification and healthcare in the third sector in England: from gift to commodity-and back?

Sheaff, R., Ellis-Paine, A. ORCID: 0000-0002-4385-5098, Exworthy, M. , Hardwick, R. & Smith, C. Q. (2023). Commodification and healthcare in the third sector in England: from gift to commodity-and back?. Public Money & Management, 44(4), pp. 298-307. doi: 10.1080/09540962.2023.2244350


When publicly-funded services are outsourced, governments still use multiple governance structures to retain some control over the services provided. Using realist methods the authors systematically compared this aspect of community health activities provided by third sector organizations in six English localities during 2020–2022. Two modes of commissioning coexisted. Commodified commissioning largely embodied Washington consensus models of formal, competitive procurement. A contrasting, collaborative mode of commissioning relied more upon relational, long-term co-operation and networking among organizations. When the two modes conflicted, commissioners often favoured the collaborative mode and sought to adjust their commissioning to make it less commodified.

Publication Type: Article
Additional Information: © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in anyway. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Publisher Keywords: Commissioning; commodification; England; inter-organization collaboration; networks; outsourcing; third sector; Washington consensus
Subjects: H Social Sciences > HD Industries. Land use. Labor
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: Bayes Business School
SWORD Depositor:
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Available under License Creative Commons Attribution Non-commercial No Derivatives.

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