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Public Policy: Using Market-Based Approaches - Department for ...

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<strong>Public</strong> <strong>Policy</strong>: <strong>Using</strong> <strong>Market</strong>-<strong>Based</strong> <strong>Approaches</strong><br />

Capacity constraints can also influence outcomes through the demand-side of<br />

the market. Customers who are unable to exercise their right to choice due to the<br />

existence of capacity constraints may become despondent and consider the<br />

allocation process unfair. This will lead to reductions in customer satisfaction,<br />

and may reduce policy per<strong>for</strong>mance against other measures if, <strong>for</strong> example, it<br />

leads to customers disengaging from the processes concerned and ceasing to<br />

participate effectively.<br />

The underlying problem here is that supply does not expand to match increasing<br />

demand, as we would expect to happen in private-sector markets. To address<br />

this problem there would need to be some mechanism to ensure that investment<br />

decisions reflect in<strong>for</strong>mation revealed by the consumer choice ‘market’ rather<br />

than being made in isolation from the scheme.<br />

Inequality of access<br />

Where consumer choice is introduced it may be that certain members of society<br />

(those who are wealthier or better educated) may be better able to exercise their<br />

right to choose. For example, those with better access to transport may find it<br />

easier to use a hospital or school of their choice. Depending on the<br />

circumstances, this may still be a better outcome than when consumers had no<br />

choice – which in the case of education can lead to the better schools being, in<br />

effect, reserved to those who can af<strong>for</strong>d to buy houses near to the most<br />

desirable schools. The problem might be reduced by measures taken to improve<br />

consumers’ ability to choose: the provision of appropriate in<strong>for</strong>mation and<br />

access to transport, <strong>for</strong> example.<br />

Inequality can be distinguished into inequalities of opportunity and outcome<br />

inequality. Inequalities of opportunity include better access to transport links, <strong>for</strong><br />

example, and may give rise to inequalities in outcomes if those with better<br />

opportunities are able to use them to obtain a superior result. Inequalities in<br />

outcomes can arise between individuals or between geographical regions.<br />

Geographical inequality is more likely to occur when mobility is low and users<br />

are effectively locked into their local suppliers. This can allow the market to<br />

develop into sub-sectors of under-per<strong>for</strong>ming suppliers located in<br />

disadvantaged areas and excellent suppliers located in more advantaged areas,<br />

with users in disadvantaged areas unable to exercise their choice by switching<br />

to a better-per<strong>for</strong>ming provider.<br />

Segregation<br />

Introducing user choice can lead to an increase in segregation through both the<br />

supply and demand sides of the market. On the supply side, segregation may<br />

arise as a result of discrimination by providers. This problem is linked to<br />

the capacity constraint problems outlined above and can be limited using<br />

the same controls. On the demand side, increased segregation can occur either<br />

as a direct result of the exercise of choice by individuals of the same<br />

ethnic/working/educational background, or as an indirect result of any increase in<br />

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