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  1. Making the internal market work : a case for managed change.

    Article - En anglais

    The internal market in the NHS is meant to ensure that provider units compete on the basis of price and quality and that money follows patients into efficient units.

    But the example of what happened to one local ophthalmology unit suggests what may go wrong when entrepreneurial activity is applied in a market that does not work perfectly.

    In 1991-2 the unit had a high workload but also comparatively high prices (because of crude pricing in the local hospital); because of pressure of work the waiting times lengthened and general practitioners increasingly complained about the service.

    The staff in the unit reopened a longstanding debate about the need for a third consultant ophthalmologist, but neither the purchasers (including fundholders) nor the provider unit were able to fund the post.

    Mots-clés Pascal : Système santé, Homme, Grande Bretagne, Royaume Uni, Europe

    Mots-clés Pascal anglais : Health system, Human, Great Britain, United Kingdom, Europe

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 94-0093220

    Code Inist : 002B30A01B. Création : 199406.