Purpose – In the mid 1990s the NHS “did” competition, in the mid 2000s the NHS is “doing” choice. This paper aims to cut through the rhetoric, highlight the differences and parallels between then and now and identify if these differences will have a different or the same impact on...

The paper derives operating and financial measures of leverage and tests their association with market based measures of equity risk. It is the first such study to use purely accounting-based data to derive the leverage measures. In line with previous literature it conducts a new test on the...