Waiting times have been a central concern in the English NHS, where care is provided free at the point of delivery and is rationed by waiting time. Pro-market reforms introduced in the NHS in the 1990s were not accompanied by large drops in waiting times. As a result, the English government in...

Since 2003, 25% of UK general practitioners’ income has been determined by the quality of their care. The 65 clinical quality indicators in this scheme (the Quality and Outcomes Framework) are in the form of ratios, with financial reward increasing linearly with the ratio between a lower and...

Financial incentives may increase performance on targeted activities and have unintended consequences for untargeted activities. An innovative pay-for-performance scheme was introduced for UK general practices in 2004. It incentivised particular quality indicators for targeted groups of...

The UK National Health Service introduced a pay for performance scheme for primary care providers in 2004/5. The scheme rewarded providers for the proportion of eligible patients who received appropriate treatment. Eligible patients were those who had been reported by the provider as having the...

Performance targets are commonly used in the public sector, despite their well known problems when organisations have multiple objectives and performance is difficult to measure. It is possible that such targets may work where there is considerable consensus that performance needs to be...

An innovative and expensive performance-related pay scheme was introduced for general practices across the UK in 2004. It was not piloted and baseline performance data were not collected prior to its introduction. We estimate the impact of this Quality and Outcomes Framework (QOF) by analysing...

According to the relative income hypothesis, an individual's health depends on the distribution of income in a reference group, as well as on the income of the individual. We use data on 231,208 individuals in Great Britain from 19 rounds of the General Household Survey between 1979 and 2000 to...

Performance targets are commonly used in the public sector, despite their well known problems when organisations have multiple objectives and performance is difficult to measure. It is possible that such targets may work where there is considerable consensus that performance needs to be...

We investigate the impact of area general practitioner (GP) supply on individual health in England. If no allowance is made for the endogeneity of GP supply, the effect is positive but not statistically significant. When GP supply is instrumented by age related capitation the effect is markedly...

Since 2003, 25% of UK general practitioners’ income has been determined by the quality of their care. The 65 clinical quality indicators in this scheme (the Quality and Outcomes Framework) are in the form of ratios, with financial reward increasing linearly with the ratio between a lower and...