The literature to date on the effect of demand uncertainty on public hospital costs and excess capacity has not taken into account the role of expense preference behaviour. Similarly, the research on expense preference behaviour has not taken demand uncertainty into account. In this paper, we...

Two remarkable aspects of the Thatcher ‘internal market’ reforms of the NHS were the focus on creating a market for hospital services and the way in which primary care was treated almost peripherally in the 1989 White Paper (Department of Health 1989a). The 1991 NHS reforms introduced...

Has government expenditure on the National Health and Personal Social Services increased significantly in real terms over the past decade? If so, where has this growth in expenditure been utilised? This paper investigates claims of real increases in expenditure by examining trends in total...

It is essential that excellence in the performance of doctors in the National Health Service is rewarded explicitly and efficiently. Unfortunately the existing system of Distinction Awards which, for the select few, can double a doctor’s public sector pay is both secretive and of unproven...

The allocation of funding and the distribution of the workforce in primary care is very unequal in England. Whilst hospital resources have been allocated in relation to a weighted capitation formula in each of the component parts of the United Kingdom since the late 1970s, there have been...

Despite the decline in rates of hospital acquired infections (HAI) since the 1950s, the level remains high and a significant proportion of them are unavoidable. International studies show that between 5.9 and 13.5 patients in every hundred are affected by hospital acquired infections, most...

Whenever the British National Health Service (NHS) appears to be short of money, the medical, political and proponents of various forms of alternative financing for health care enjoy a resurgence. What would be the economic effects of changing the financial base of the NHS from general taxation...

Functional dyspepsia can be defined as chronic or recurrent upper abdominal pain or discomfort, for which no focal lesion or systemic disease can be found. It is a common complaint seen by physicians and, although it does not cause death or severe disability in the majority of cases, represents...

The combination of different skills used to provide particular types of primary and hospital care varies considerably from general practice to general practice and from hospital to hospital. Furthermore, skill mixes are changing rapidly as decision makers attempt both to reduce labour costs and...