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Welfare Reform on the Web (August 2007): National Health Service - funding

Economists' dream or nightmare? Maximizing health gains from available resources using the NICE guidelines

S. Birch and A. Gafni

Health Economics, Policy and Law, vol. 2, 2007, p. 193-202

The adoption of economic evaluation guidelines by decision-making bodies in several countries has seen the institutionalisation of economics as a basis for decision-making aimed at getting maximum output from whatever resources are committed to healthcare. The National Institute for Clinical Excellence (NICE) is perhaps the most widely discussed example of this approach. The original NICE guidelines proved unsatisfactory and in fact led to cost escalation without proof of any net health gain in the first 2.5 years of their existence. A revised set of guidelines was subsequently developed and launched in 2004, which are evaluated in this article.

(For comment see Health Economics, Policy and Law, vol.2, 2007, p. 203-221)

Moving down the line to financial stability

C. Ham

Health Service Journal, vol.117, July 19th 2007, p. 18-19

The introduction of competition and patient choice into the NHS brings the issue of managing financial deficits to the fore. Some providers will attract additional patients and income, but others may see a drop in demand. Struggling organisations may be saved through support from Department of Health turnaround teams or by merging with high performing trusts, as in the case of the acquisition of the failing Good Hope Hospital trust by Heart of England. Plans now need to be developed to deal with cases of insolvency.

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