Five years after the implementation of the UK health and social care reforms it is still difficult to evaluate objectively their success or failure. It is an opportune time to stand back and assess what were the real objectives of the reforms, and what have been their essential features. The...

Contracting has played a central role in the NHS reforms as the principal mechanism by which resources are transferred from purchasers to providers. The nature, process and role of contracting are traced by examining the development of government policy on this issue since the inception of the...

This paper traces the development of costing and pricing guidance as it relates to the operation of the NHS internal market (Sections 1 and 2). Such guidance has developed at least partly in response to the information deficiencies which undermine the Government’s somewhat mechanistic...

The purchaser/provider split within the NHS has highlighted the role of District Health Authorities (DHAs) in assessing health needs and buying services to meet those needs. This requires a consideration of what is meant by “need” and how it relates to a system of priorities for health care...

In this paper we argue on the merits of theoretical simulation, a widely used technique in other areas of theoretical economics, to extending the phase diagram analysis of the Grossman's 1972 model of investment in health capital. We argue that theoretical simulations are particularly useful...

Rationale Increasing attention is being given to the evaluation of public health interventions. Methods for the economic evaluation of clinical interventions are well established. In contrast, the economic evaluation of public health interventions raises additional methodological challenges. The...

Any country designing a national health system today has the advantage that virtually every structure which it might be considering has been tried, to some degree or another, by some other country. Looking at evidence from those experiments yields a number of broad conclusions. Most importantly,...