Competition and management

There is now wide recognition that the UK National Health Service needs to be reformed, and there is particular recognition that something needs to be done about incentives. Hence there is now to be a scheme to link the pay of the 800‐odd NHS general managers to their performancce. And if a recent Government discussion document is approved, the general practitioners’ contract may be reorganised to incorporate a ‘good practice allowance’. Moreover, according to the same document: ‘The government believes that the freedom of patients to choose their doctor can be an effective influence on the quality of services’.