Despite radical reform in the NHS and the creation of purchaser-provider contracting, the pattern of doctors’ remuneration remains largely unaltered. Doctors are the key agents in access to the health care system, and the services they control determines who survives and who lives in pain and...

Pharmaceutical prescribing currently represents around 10% of total National Health Service expenditure, and is one of the most inflationary elements of spending (Parliamentary Office of Science and Technology 1993). Between 1980 and 1990, the overall cost of a prescription increased by 19%....

Non-steroidal anti-inflammatory drugs (NSAIDs) are used widely throughout the world to relieve the symptoms of musculoskeletal disorders, in particular osteoarthritis and rheumatoid arthritis. These drugs produce significant side effects, including gastro-intestinal ulceration and the associated...

Two remarkable aspects of the Thatcher ‘internal market’ reforms of the NHS were the focus on creating a market for hospital services and the way in which primary care was treated almost peripherally in the 1989 White Paper (Department of Health 1989a). The 1991 NHS reforms introduced...

Has government expenditure on the National Health and Personal Social Services increased significantly in real terms over the past decade? If so, where has this growth in expenditure been utilised? This paper investigates claims of real increases in expenditure by examining trends in total...

It is essential that excellence in the performance of doctors in the National Health Service is rewarded explicitly and efficiently. Unfortunately the existing system of Distinction Awards which, for the select few, can double a doctor’s public sector pay is both secretive and of unproven...

The allocation of funding and the distribution of the workforce in primary care is very unequal in England. Whilst hospital resources have been allocated in relation to a weighted capitation formula in each of the component parts of the United Kingdom since the late 1970s, there have been...