<title/> Labour's new approach to primary health care, based around the policy of practice-based commissioning, has considerable potential for learning from the general practitioner fundholding reforms put in place by the Conservative governments of the 1990s. However, practice-based commissioning seems...

Every year the United Kingdom central government assesses the relative spending needs of English local authorities in respect of the services for which is it responsible. This is done by estimating a Standard Spending Assessment (SSA) for each service, which is intended to indicate the spending...

Contracting has played a central role in the NHS reforms as the principal mechanism by which resources are transferred from purchasers to providers. The nature, process and role of contracting are traced by examining the development of government policy on this issue since the inception of the...

Policy-makers are increasingly advocating market-based reforms to increase choices for service users and therefore to drive improvement through competition. This article assesses this approach in a hospital trust where there is plenty of scope for patients to choose providers and so for reforms...

The English National Health Service is introducing ‘Payment by Results’ so that hospitals are paid according to the activity they undertake. This should encourage hospitals to increase activity but perhaps to unaffordable levels. Drawing on interviews with NHS staff and documentary evidence,...

All Iranian hospitals have been subject to a grading system which determines the payments they can charge. We examined all possible pathways through which the grading system could influence hospitals’ adherence to audited standards.