Suchergebnisse

This paper argues that planned health care provision and market regulation play distinct roles in relation to the effective provision of equitable health care. Governmental planned provision has as a core objective ensuring that the health system is redistributive and that the poor have access to competent care. Market regulation has as its central objective the shaping of the role and behaviour of the private sector within the health system. Management of the health system as a whole, which is a governmental responsibility, therefore requires the integration of planning and regulation in a manner appropriate to each particular context.

Local authorities increasingly use 'trading' language to describe and debate inter and intra-departmental working relations. This article explores the meanings given to this contested language in context, drawing on case studies of internal trading in two authorities. The objective of this interpretative exercise in economic discourse is to explore the extent to which a dominant discourse of internal 'trading' exists within the two authorities, and its association with identifiable patterns of economic behaviour. The article identifies four discourses of internal 'exchange', of which two, labelled the 'trading' and the 'public business' discourses, are widely shared and attempt to ally social and public concern with devolved financial management to business-like behaviour. Each of these two discourses was identified with distinct policies and preferred behaviour in internal working relations. Neither was 'winning': we are a long way from the solidifying of a single new internal economic culture in local government through the language of trade.