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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...

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...

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...

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...

In the 1990s, countries experimented with two models of health care reforms based on choice of provider and insurer. The governments of the UK, Italy, Sweden and New Zealand introduced relatively quickly ‘internal market’ models into their single-payer systems, to transform hierarchies into...

Although choice may be seen as an end in itself, the papers included in this special issue of <italic>Health Economics, Policy and Law</italic>, examine choice policies in European systems of health care, which aim to be effective instruments for ameliorating the systemic pressures from the iron triangle of...