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This article examines how rationing issues are managed by the British National Health Service. The author, focusing on health care reforms, examines the government's role in making health care decisions and determining priorities regarding medical rationing and maintains social and economic changes shifts the mentality of government.

The reforms of the UK National Health Service proposed by Prime Minister Tony Blair in 2000 are a gamble that may not pay off. Blair promised more money for the service, as well as more hospital beds, more doctors and nurses, and shorter waiting lists.

This article discusses the New Labour Party's policy toward the National Health Service (NHS) in Great Britain, which includes a commitment to the principles of the service, modernization, and a simplistic way of achieving change. The NHS in Britain is compared with health care services in France and Germany; the authors assert the strong and weak points, and the lack of ideas for reform by both the previous Conservative and late 1990s New Labour governments.

This paper draws on audio-recordings of a Health Authority's contract monitoring meetings with hospital providers to examine the nature of interactions between managers and clinical professionals in the British National Health Service internal market. It describes how managers and professionals arrive at a working division of labour, which acknowledges their respective spheres of expertise, but also leaves a space where definitions are contested. There is an interplay of competing managerial and professional discourses which construct problems and proposed solutions in fundamentally non-commensurable ways. Yet only rarely do managers or professionals mount challenges in ways that bring them on to the territory of the other group; rather each group seeks to frame problems to mesh with its special domain of competence. Managers seek to push back the boundaries of professional control by constructing a language and set of practices which will govern the contracting process. But they remain reliant on professionals to mediate between the requirements of contracting and the realities of clinical work. Clinical arguments continue to have high perceived legitimacy for managers, and will often be taken up by hospital managers in negotiations with their Health Authority counterparts. It is argued that the dependency of managers on professionals to make the contracting system work, taken together with the continued social and cultural authority of senior medical consultants, limits managers' ability to control professionals.

The United Kingdom government set out proposals for reorganising the National Health Service (NHS) in a Dec 1997 White Paper. These proposals have to be seen in the context of earlier reforms carried out in 1991. Both reform projects aim to save resources and increase the cost-effectiveness of the NHS. The NHS has been affected by long waiting lists and the closure of hospital wards. Expectations for medical care have risen, and an ageing population has also increased demand. There is speculation that charges may be made for NHS services.

A GREAT deal has been written about Thatcherism. However, the period since 1979 will continue to provide much of the data which political scientists will use to examine broader theoretical [...]

Reforms to the UK National Health Service were introduced in Apr. 1991 to cut too much vertical integration by implementing a quasi-market where incentive structures and greater availability of information would allow decision makers to more effectively use resources. However, a general framework with which to examine the welfare gains or losses resulting from the quasi-market is yet to be implemented. To correct the situation, an analytical framework of a quasi-market within which distortions such as cream skimming and local monopoly can be investigated.

The debate on quality in health care in the UK has resurfaced as a result of health care reforms, including the the introduction of GP (General Practitioners) fundholding and the patients' charter. The development of quality issues in General Practice in the UK were examined using a two-stage approach. The first stage sought to provide an understanding of key questions, while the second stage involved a questionnaire derived mainly from attitude elements identified from the first stage. Findings indicated that managing service quality is an important challenge facing GPs., Examines the debate on quality in health care in light of GP fundholding and the Patients' Charter. Focuses on the development of quality issues in General Practice by carrying out [...]

The provisions of the UK Health and Social Care Bill and its implications for the National Health Service and social services are examined. The rationale for merging primary care and community care under new Care Trusts is analysed.

UK's top health experts have come up with a report that recommended debate on such issues as health care rationing and pertinent financial issues. Known as Healthcare 2000, the group recommended that the National Health Service gradually relinquish its role as provider of a 'universal' service to give way to a healthcare rationing system to give patients greater choice. The recommendation is unpopular with politicians in light of the forthcoming elections and they are therefore unwilling to discuss it.

"The recently published National Health Service (NHS) Plan sets out some core principles on which the NHS is to be based. One states that the NHS "will work continuously to [...]

An enhanced role for primary health care (PHC) is currently a matter of political priority in the UK. This higher profile is drawing attention to a range of unresolved challenges and issues, relating to both the structure and content of provision, which currently permeate the system. Running in parallel with this is a recognition that: to date, PHC has been under-researched; that, as a result, our understanding of it is frequently poor; and that, as a consequence, fresh perspectives are needed in order to effectively research this uncertain, evolving and increasingly important healthcare sector. In this paper we argue that social worlds theory (SWT) provides, albeit in a suitably modified form, an ideal conceptual framework for the analysis of contemporary primary care. SWT is an approach which assumes complexity and constant evolution, and its core concepts are directed towards unravelling the consequences of encounters between different interest groups -- something which is of particular utility at this time given the increasing attention to user participation, and an ongoing questioning of established patterns of professional authority. It is an approach which has rarely been employed empirically, even beyond medicine. In order to illustrate the wide relevance of the approach, we discuss how it can facilitate research at all levels of PHC: i.e., in relation to aspects of medical practice (the case of medically unexplained symptoms); shifts in service organisation (changing professional roles and the introduction of policy reforms); and issues which straddle both organisation and content (the increasing use of complementary medicine in primary care). In each case the approach is able to embrace the complexity of situations characterised by the intersection of professional and lay social worlds and is able to provide the conceptual tools through which resultant processes can be tracked and investigated. Keywords: Multiple stakeholders; Primary care; Social worlds theory