POLITICS AND PROCEDURES - THE STRATEGY PROCESS IN A HEALTH COMMISSION

One of the objectives for the NHS and Community Care Act, 1990 was tha t health care services in future would be tied more closely to local n eeds. Unfettered by historic patterns of resource allocation which ref lected senior consultants' preferences in both clinical practice and c ommittee, the new purchaser/provider split was to enable a changed app roach to health service development. One group of major purchasers of health care, the health commissions, are required to research the heal th needs of the local population and to determine appropriate and poss ibly radical service models in a manner which is at once both scientif ically rational and politically sensitive. A study undertaken in a hea lth commission over a 16-month period analysed this process in two pur chasing strategies.