Clinical Effectiveness in the National Health Service in Scotland

In the industrialized West, the welfare state has undergone reforms of varying significance during the past two decades. At the root of these transformations has been the ascendancy of neo-liberal thought, grasped by an eager political class desperate to find ways out of the apparent mire of postwar...

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Bibliographic Details
Published in:Journal of economic issues 1999-03, Vol.33 (1), p.117-139
Main Authors: Keaney, Michael, Lorimer, A. R.
Format: Article
Language:English
Subjects:
Analysis
Auditing standards
Cost effectiveness analysis
Cost efficiency
Effectiveness
Financial audits
Government agencies
Great Britain
Health care
Health care costs
Health care economics
Health outcomes
Health policy
Health services administration
Medical audits
Medical economics
Medical practice
Medical sector
Medical service, State
National health service
Neoclassical economics
Physician and patient
Reforms
Scotland
Studies
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Summary:In the industrialized West, the welfare state has undergone reforms of varying significance during the past two decades. At the root of these transformations has been the ascendancy of neo-liberal thought, grasped by an eager political class desperate to find ways out of the apparent mire of postwar Keynesianism. One consequence of this is that the National Health Service (NHS) in Scotland has undergone various organizational upheavals since 1979, which have attracted both praised and criticism. NHS reforms were geared to the promotion of greater managerial efficiency through the institution of quasi markets. As a result, it has been said that a greater market sensibility has, for the first time, been made clinicians more aware of the actual costs of treatment and has therefore focused thinking on optimizing outcomes with the level of resources. The downside of these development has been the effects of staff morale, the public's perceptions of general malaise caused by underfunding, and emergent managerialism.
ISSN:0021-3624
1946-326X
DOI:10.1080/00213624.1999.11506138