The Internal Market of the National Health Service: Some Early Observations from the Freeman Hospital, Newcastle upon Tyne

Deals first, with the theoretical framework within which the Internal Market (NHSIM) is expected to operate and the particular problems which occur when a service is provided to a consumer free at the point of consumption (i.e. non‐marketed). Second, deals with some costing procedures and stresses the importance of considering costs of an episode jointly with other benefits. Both of these activities are at a relatively early stage in the NHS in general. Third and fourth, deals with two examples (internal medicine and cardiothoracic surgery) of how the NHSIM has fared during the first year at the Freeman Hospital,Newcastle upon Tyne. Shows how principles of the theory of finance may be applied to contracting for Coronary Artery Bypass Graftings.