The 1991 reforms to the UK NHS created a group of buyers of hospital care f
rom amongst primary care physicians. The implementation of the reforms was
such that these buyers had incentives to increase their use of hospital ser
vices prior to entering the scheme in order to inflate their budgets. It ha
s been argued that non-financial motives would limit such behaviour. The pa
per shows that these health care providers did respond to the financial inc
entives offered by the scheme, increasing hospital-based activity prior to
entry, and so inflating their budgets upwards for the duration of the fundh
olding scheme. (C) 2001 Elsevier Science B.V. All rights reserved.