Towards Effective Purchasing for Health: meeting the challenge



After an uncertain start following the implementation of the NHS changes in 1991, purchasing is now viewed as the engine for change both in the future configuration of health care services and in the achievement of health gain for local populations. Purchasing’s top place on the policy agenda was secured during 1993 when the then health minister, Dr Brian Mawhinney, sought to articulate in a series of keynote speeches the vision and direction for purchasing (Mawhinney and Nichol, 1993). For Mawhinney, ‘purchasing is about change … Its importance lies in its capacity to anticipate and adapt to change’ (ibid., pp. 3–4).


Health Authority Labour Party Public Health Management Public Health Setting Public Health Medicine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Alderslade, R. and D. Hunter (1992) ‘Forward March’, Health Service Journal, 102, 19 March, 22–3.Google Scholar
  2. Alderslade, R. and D.J. Hunter (1994) ‘Commissioning and Public Health’, Journal of Management in Medicine, 8, No. 6, 20–31.CrossRefGoogle Scholar
  3. Appleby, J., P. Smith, W. Ranade, V. Little and R. Robinson (1994), ‘Monitoring Managed Competition’, in R. Robinson and J. Le Grand (eds), Evaluating the NHS Reforms (London: King’s Fund Institute).Google Scholar
  4. Association of Metropolitan Authorities (1994) Local Authorities and Health Services: The Future Role of Local Authorities in the Provision of Health Services (London: AMA).Google Scholar
  5. Caiman, K., The Scientific Basis of Public Health (1993) (Address to the Annual Conference of the Faculty of Public Health Medicine, Glasgow).Google Scholar
  6. Clarke, M., D.J. Hunter and G. Wistow (1994) Local Government and the National Health Service: The New Agenda (London: Local Government Management Board).Google Scholar
  7. Department of Health (1993) Public Health: Responsibilities of the NHS and Roles of Others: Advice of the Committee Set up to Undertake a Review of HC(88)64) (Abrams Report) (London: DoH).Google Scholar
  8. East Anglian RHA (1994) Power to the People? Rubber Windmill 4 (Cambridge: East Anglian RHA).Google Scholar
  9. Eskin, F. (1991) ‘The Art of Public Health Medicine’, Public Health, 105, 555–61.CrossRefGoogle Scholar
  10. Gurney, B.H. (1994) Public Participation in Health Care. A Report to the East Anglian RHA (Cambridge: Health Sciences Research Group, University of Cambridge).Google Scholar
  11. Harris, A., and J. Shapiro (1994) ‘Purchasers, Professionals, and Public Health’, British Medical Journal, 308, 12 February, 426–7.CrossRefGoogle Scholar
  12. Harrison, S., D.J. Hunter, I.H. Johnston, N. Nicholson, C. Thunhurst and G. Wistow (1991) Health Before Health Care, Social Policy Paper No. 4 (London: Institute for Public Policy Research).Google Scholar
  13. Harrison, S., and N. Freemantle (eds) (1994) Working for Patients: Early Research Findings (Leeds: Nuffield Institute for Health).Google Scholar
  14. Hunter, D. (1993) ‘No More Corporate Fudge’, Health Service Journal, 103, 9 September, 20–2.Google Scholar
  15. Hunter, D.J. and S. Harrison (1993) Effective Purchasing for Health Care: Proposals for the First Five Years (Leeds: Nuffield Institute for Health Services Studies).Google Scholar
  16. Klein, R. (1994) ‘Can we Restrict the Health Care Menu?’, Health Policy, 27, 103–12.CrossRefGoogle Scholar
  17. Labour Party (1995) Renewing the NHS (London: The Labour Party).Google Scholar
  18. Le Grand, J. (1994) ‘Evaluating the NHS Reforms’, in R. Robinson and J. Le Grand (eds), Evaluating the NHS Reforms (London: King’s Fund Institute).Google Scholar
  19. Le Grand, J. and W. Bartlett (1993) Quasi-Markets and Social Policy (London: Macmillan).Google Scholar
  20. Lloyd, P. (1994) ‘Management Competencies in Health for All/New Public Health Settings’, Journal of Health Administrative Education, 12, 187–207.Google Scholar
  21. Mawhinney, B. and D. Nichol, (1993) Purchasing for Health: A Framework for Action (Leeds: NHS Management Executive).Google Scholar
  22. NHS Executive (1994) Developing NHS Purchasing and GP Fundholding, EL(94)79, (Leeds: NHS Executive).Google Scholar
  23. NHS Executive (1995) An Accountability Framework for GP Fundholding, EL(95)54 (Leeds: NHS Executive).Google Scholar
  24. North Derbyshire Health Authority (1994) Listening and Responding to Local People (Chesterfield: North Derbyshire Health Authority).Google Scholar
  25. Organisation for Economic Cooperation and Development (OECD) (1994) OECD Economic Surveys 1993–94: United Kingdom, (Paris: OECD).Google Scholar
  26. Redmayne, S. (1995) Reshaping the NHS, Research Paper No. 10 (Birmingham: National Association of Health Authorities and Trusts).Google Scholar
  27. Redmayne, S., R. Klein and P. Day, (1993) Sharing Out Resources (Birmingham: National Association of Health Authorities and Trusts).Google Scholar
  28. Richardson, A., M. Duggan and D.J. Hunter (1994) Adapting to New Tasks: The Role of Public Health Physicians in Purchasing Health Care (Leeds: Nuffield Institute for Health).Google Scholar
  29. Robinson, R. and J. Le Grand (eds) (1994) Evaluating the NHS Reforms (London: King’s Fund Institute).Google Scholar
  30. Tilley, I. (ed.) (1993) Managing the Internal Market (London: Paul Chapman Publishing).Google Scholar

Copyright information

© David Hunter 1997

Authors and Affiliations

There are no affiliations available

Personalised recommendations