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...

It is remarkable how health care systems, created over decades and influenced by very different cultures exhibit similar problems. Most health care systems are compartmentalised with managers at margins responding to perverse incentives and seeking to shift patients and costs onto rival...

The current debate about reforming the NHS is surprising in a number of ways. Timmins (1988) points out that it was unforeseen and not part of the Government’s main concerns after winning the election in June 1987. It is surprising in another way because it is only six years ago since there...

Throughout the world there is a recognition that the delivery of health care is ineffective and that these unpleasant outcomes are a product of the perverse incentives inherent in all health care systems. In New Zealand the Government documented the defects of the health care system and is now...

Dental care was never fully integrated into the welfare state in Finland, but in 1986 it was decided to improve access to both publicly and privately provided dental care by reducing the price paid by patients. Since this would have been rather expensive to do for the whole population, it was...

The current period of fundamental political change in South Africa offers a window of opportunity for the implementation of transformative health policies. The South African health system is presently characterised by considerable fragmentation of health service provision and administration,...