Over the last decade the British Labour Government has presided over unprecedented increases in levels of spending on the National Health Service (NHS). But Opposition parties now claim that this record growth in NHS expenditure has been misspent, and some commentators are already predicting...

STUDY OBJECTIVE: To determine the relative costs of prostheses and factors associated with changes in these cost rankings. DESIGN AND SETTING: Economic model using published data. MAIN RESULTS: The main cost drivers are current costs and revision rates. Expected revision costs are a small...

Improving accountability in public services has been a central ob-jective of many public sector reforms in recent years. Chief amongthese have been efforts to generate observable performance measuresas a basis for monitoring performance. This paper examines a nat-ural experiment in regimes...

This paper examines problems of setting targets for health care performance in which the centre sets a uniform set of targets and levels of performance. The case study examined by the paper is from the system of performance assessment of ‘star ratings’ that was introduced from 2001...

This article considers how the 'accidental logics' of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing,...

In a relatively short time, regulation has become a significant and distinct feature of how modern states wish to govern and steer their economy and society. Whereas the former ‘dirigiste’ state used to be closely related to public ownership (e.g. hospitals), planning (volume and capacity...