The successful implementation of the NHS reforms hinges on the development of district health authorities as effective purchasers of health care for their residents. The NHS has always been provider driven and if services are to be delivered more efficiently and responsively then it is essential that health authorities are ...
The first part of this briefing looks at the implications of the NHS reforms in theory and in practice and presents the six lines of enquiry which might be pursued. The second section discusses the particular impact of the NHS reforms on London which has maintained a very significant number ...
This report reviews the performance of health services in Sweden, Holland, West Germany, Canada and USA. The main aim has been to identify the countries' studies, to draw parallels with the UK, and to establish the lessons, if any, from abroad. Chapter one traces the origins of the Prime Minister's ...
This study describes the various approaches adopted by some DHAs in separating responsibility for purchasing and providing services. The approach finding most favour involves separating the purchaser and provider functions below the DGM (District General Manager) level. The strength of this approach is in enabling the purchaser and provider functions ...
The briefing paper provides a constructive analysis of the White Paper (Working for Patients). It argues that the White Paper outlines an ambitious and high risk strategy. The paper identifies main themes underlying the White Paper proposals: new institutional arrangements for the health services; the management of clinical activity; responsiveness ...
This briefing paper analyses the management of clinical activity in the NHS. It does so against a background of increasing concern that practices are not always as effective or efficient as is sometimes claimed. The paper considers critically the various policy options that have been put forward for tackling this ...
This paper reviews the available evidence on medical negligence and analyses the options facing policy makers. It shows that claim rates in the United Kingdom are much lower than in the United States. Differences between the two countries in legal, health care and social insurance systems mean that it is ...
In the current debate surrounding methods of health finance, there has been no shortage of proposals for reform, but there has been a serious shortage of careful analysis of these proposals. This is the main aim of this briefing paper. Through a systematic examination of policy choices, it seeks to ...
This report presents the results of the authors' review of experience of health care technology assessment in the UK and overseas. It was prepared principally to inform the programme of work on technology assessment being developed at the King's Fund Institute, and was a benchmark exercise, seekingto establish the state ...
This paper is concerned with policy making in the Swedish health service. The paper begins with a description of the organisation of the Swedish health service and a brief summary of the main issues of debate within the service. This is followed by an examination of the role of the ...