Coping With Cutbacks and Managing Retrenchment in Health
- 1 April 1991
- journal article
- research article
- Published by Cambridge University Press (CUP) in Journal of Social Policy
- Vol. 20 (2) , 215-236
- https://doi.org/10.1017/s0047279400018729
Abstract
This paper presents qualitative evidence about managers' perceptions of retrenchment in the National Health Service in England. It outlines the financial situation of six case-study district health authorities during the expenditure crisis of 1987/8, and presents the results of an interview survey of district general managers and directors of finance about the implementation of cutbacks. Similar policies of cost-containment and service reduction are mirrored by similarity in the views held by managers and treasurers. Key concerns included the need for a reconstruction of local priorities in service provision, and the advocacy of an extension of managerial control over hospital consultants. These issues are discussed briefly in the context of the recent government proposals to introduce market mechanisms into the NHS, and wider arguments about medical dominance and bureaucratic/professional conflicts.Keywords
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