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...

The latest return to service planning in the NHS, while harnessing the perceived benefits of previous market approaches, nevertheless signals a radical change in the long-term role of the Health Authority. It is timely to examine the actual objectives of Health Authorities in view of their...

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...