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...

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...

In this paper there is an attempt to demonstrate the relevance of economics to the provision of mental health care and to describe how one technique in the economist’s toolkit should be applied in this field if the objective of policy is to use society’s scarce resources efficiently. The...

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...

Whenever the British National Health Service (NHS) appears to be short of money, the medical, political and proponents of various forms of alternative financing for health care enjoy a resurgence. What would be the economic effects of changing the financial base of the NHS from general taxation...

Functional dyspepsia can be defined as chronic or recurrent upper abdominal pain or discomfort, for which no focal lesion or systemic disease can be found. It is a common complaint seen by physicians and, although it does not cause death or severe disability in the majority of cases, represents...

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...