The combination of different skills used to provide particular types of primary and hospital care varies considerably from general practice to general practice and from hospital to hospital. Furthermore, skill mixes are changing rapidly as decision makers attempt both to reduce labour costs and...

This paper consists of a review of economic evaluations of mental health care. The conclusion which emerges from this review is that the existing literature is lacking in both quantity and quality. Only seven evaluations of both the costs and effects of alternative forms of mental health care...

As the number of those with HIV-AIDS increases, an important concern is to understand the pattern and range of social care needs and how best these can be met. This paper relates to the report of a two-year project, funded jointly by the Department of Health (DH) and the Scottish Education...

Over the last 50 years there has been a regular cycle of Government committees which have forecast “shortages” and “surpluses” in medical manpower. It is remarkable how little change there has been in the methods used in these forecasts. This has occurred despite regular critiques of the...

This is a follow-up paper arising from a World Health Organisation meeting which was held in Disley (near Manchester) in England in September 1984. The original paper for that conference (Maynard (1984)) was revised as a result of comments perceived at the Disley meeting and circulated to...

The provision of health and social care for people with HIV infection or AIDS and for initiatives aimed at the prevention of the spread of HIV infection has since 1988-89 relied heavily on ring fenced Central Government funding. In 1990/91 the total earmarked central funds available for English...

The purpose of this study was to estimate the costs and benefits of the use of erythropoietin (EPO) in the treatment of anaemia arising from chronic renal failure. Recurrent dialysis of chronic renal failure (CRF) patients results in their haemoglobin being depleted and the patient becoming...

It is imperative that health care resources are spent as efficiently as possible by committing them to demonstrably cost-effective treatments and procedures. The NHS reforms of 1989 aimed to help achieve this by separating out the roles of purchaser and provider. In doing so, ‘trade’ between...

The current debate about reforming the NHS is surprising in a number of ways. Timmins (1988) points out that it was unforeseen and not part of the Government’s main concerns after winning the election in June 1987. It is surprising in another way because it is only six years ago since there...

Since the mid 1980s the imprecise nature of the GPs’ contract and the lack of knowledge about what services were provided by general practitioners has created much argument and radical changes in the terms and conditions in the GPs’ contract. The old contract required a general practitioner...