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Discusses managerial objectives in the National Health Service and compares service to patients with financial considerations. Reviews the growing influence of financial criteria and the manner in which financial objectives have been introduced. Asks if managers see their mission in terms of financial targets or patient service. Reports on the results of a questionnaire survey of all the managers in the provider units within two District Health Authorities. Managers were asked to rank a set of five statements in order of the extent to which they agree with them. Analysis of the overall results shows a large measure of agreement within the group of respondents that service to patients ranks first, with financial aspects coming last. The same outcome occurred when the results were disaggregated to NHS Trust/non‐Trust level and between staff categories.

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