CONTROL IN THE NATIONAL-HEALTH-SERVICE

This paper reviews the objectives behind the installation of control s ystems within the National Health Service. It outlines how the introdu ction of market concepts in the National Health Service necessarily ch anges the objectives of the service and hence its control systems, par ticularly its financial control systems. The paper then examines vario us control models, to establish exactly what elements are being contro lled and to diagnose some of the shortcomings of the existing system. In conclusion, the authors point to the need for a recognition of mult iple (and often conflicting) objectives and for more open debate about the appropriateness of the current simplistic measures to overcome th e danger that the faults of the original control system will emerge ag ain, with an emphasis on inputs into the system rather than outputs.