LOCAL VOICES IN AN INTERNAL MARKET - THE CASE OF COMMUNITY-HEALTH SERVICES

This paper presents findings from a study of contract specification an d implementation in community health services (CHS). In this paper, we focus on one aspect of that study: the role of local people in inform ing the assessment of health needs and in determining the provision of community health services in the context of the NHS ''internal market ''. The paper is based on fieldwork undertaken in three districts with in one region. Analysis of data obtained from these localities suggest s that while there appears to be a genuine commitment to the principle of local involvement, ideas about how that involvement can be built i nto the activities of either purchasers or providers are less transpar ent.