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The World Bank's Global Burden of Disease Study pioneered the use of Disability Adjusted Life Years (DALYs). In this paper we distinguish between the total and the “avoidable” burden of disease. We identify different ways of measuring DALYs: incidence‐based DALYs are appropriate where the...

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The NHS reforms introduced on 1 April 1999 were intended to remove competition and promote co-operation in the delivery of health care. This was to be achieved in part by the development of joint working by groups of General Practitioner (GP) practices covering populations of around...

Although information on variations in health service performance is now more widely available, relatively little is known about how healthcare payers use this information to improve resource allocation. We explore to what extent and how Primary Care Trusts (PCTs) in England have used the NHS...

Prior to devolution in 1999, governance of schools and hospitals in England and Wales was similar. After devolution, the funding and organization continued to be similar, but the two governments adopted different policies in the pursuit of common objectives. This paper reports the results of two...

Gwyn Bevan and Matthew Skellern review evidence on the effects of hospital competition on quality of care within the English NHS and question whether they support government proposals to extend competition.

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...