title: NHS reforms. Counting the costs.
abstract: Localism predominates in purchaser-provider relationships, with markets strictly limited in practice. Block contracting predominates, largely to enable purchasers to bring pressure to bear on providers' costs and outputs. The administrative costs of operating the purchaser-provider split have led to a clear growth in the overall administrative costs within the NHS. Locality commissioning may conflict with the need to reorganise clinical services.
authors.affiliation: Centre for Health Planning and Management, Keele University, UK.
authors.forename: C
authors.initials: C
authors.lastname: Paton
authors.forename: K
authors.initials: K
authors.lastname: Birch
authors.forename: K
authors.initials: K
authors.lastname: Hunt
authors.forename: K
authors.initials: K
authors.lastname: Jordan
authors.forename: J
authors.initials: J
authors.lastname: Durose
mesh_terms: D003284:Contract Services / Q000191:economics*; D003365:Costs and Cost Analysis; D004465:Economic Competition / Q000639:trends*; D018166:Health Care Reform / Q000191:economics*; D019538:Health Care Surveys; D006292:Health Priorities; D013222:State Medicine / Q000191:economics*; D006113:United Kingdom