The Attitudes of NHS Clinicians and Medical Managers Towards Changes in Accounting Controls

Clinical directors and medical managers expected accounting information would assume high importance for institutional control as a consequence of NHS reforms. However, clinical directors were not comfortable with the symbolism of formal accounting controls. Their individual understanding of accounting information varied, but was modest overall. Medical managers were more inclined to accept and respond to financial controls. However, acceptance and response was frustrated for all users by inaccuracy and lateness of accounting reports. Cost savings were prompted more by established professional attitudes than in response to accounting reports. Non-financial controls remained the dominant mode of operational control.     

Co-production in research: some reflections on the experience of engaging practitioners in health research

This article reports the activities undertaken to develop co-production in health research. It is a response to the call for more discussion of the issue made in an earlier issue of this journal. Consideration of the practicalities of undertaking research in this way is an important contribution to the debate.     

The Politics of Accountability: Institutionalising Internal Auditing in Israel

Israel's attempt at strengthening public sector internal audit is found to have limited success, conforming with experiences of other countries. The adopted internal audit policy had little more than symbolic value, being devoid of stipulations to affect significant change. This is confirmed by implementation data that reveal low scores for most organizations across dimensions of structure, process and outcome. Politics of accountability and policy change models help to explain the causes of ineffectual internal audit legislation and of weak implementation. Findings suggest that top–down approaches to strengthening public sector internal audit are misplaced.     

New development: Commercialization of the English National Health Service: a necessity in times of financial austerity?

ABSTRACT

This article examines income received by National Health Service (NHS) providers from non-NHS sources. In 2015–2016, it amounted to 9.1% of their revenue. In the English NHS, there is an increasing reliance on non-NHS income to provide revenue for NHS organizations, due in part to government’s austere financial plans. This article is the first comprehensive analysis of these financial data for all English organizations. It provides new evidence in the ongoing debate about the nature and values of public service organisations and the role of commercial imperatives.     

Accounting and the emergence of care pathways in the National Health Service

This paper examines the effects of New Public Management reforms on the information infrastructure underpinning the work of public service professionals. Focussing on the case of the British National Health Service (NHS), the paper argues that hospital accounting reforms played a significant role in the emergence of standardised models of clinical practice. The paper moreover argues that, under the label ‘care pathways’, such standardised models of clinical practice became embedded in the information infrastructure of the NHS and concludes by discussing their implications for the work of doctors and hospital accountants.     

中国台湾全民健康保险财务危机论析

台湾全民健康保险从1995年实施至今取得了显著成效,但是,台湾健保也面临着严重的财务问题,目前已经爆发了3次财务危机。虽然采取开源节流、调整保险费率等一系列措施,但收效甚微,健保财务依然入不敷出。健保财务危机屡屡爆发,根源在于健保自身的制度缺陷。要达成健保的财务平衡,应该从健保的制度层面上做一番彻底而有效的改革。     

The Attitudes of British National Health Service Managers and Clinicians Towards the Introduction of Benchmarking

This paper describes an empirical study, conducted in three acute hospitals, of the attitudes of central managers, medical managers and clinicians towards the adoption of benchmarking. Benchmarking was portrayed in The New NHS White Paper (1997) as an important means of improving efficiency over the next decade. The present paper examines the context of change and nature of benchmarking. Findings are presented in seven sections including: the understanding which respondents had of benchmarking; their willingness to be involved in benchmarking; the existence of strategies and policies for implementing benchmarking; the relevance of existing costing information; and the role of networks in facilitating benchmarking. The study concludes that the process of change adopted contradicted most of the factors associated with creating receptivity to change. Also, that the publication of the National Reference Costs seemed to have more relevance to resource planning at central National Health Service Management Executive level, than to effecting improvements at operational level in acute hospitals.     

金融市场开放背景下信用卡业务发展态势研究

信用卡业务是现代商业银行的重点业务,在国内金融市场全面开放后,我国银行业如何迎接这一挑战将在一定程度上影响着自身的竞争能力.本文从分析国内银行卡业务的发展现状出发,详细阐述了信用卡业务竞争激烈的原因、外资银行在信用卡业务上具有的优势,以及国内商业银行在信用卡业务上面临的挑战.在此基础上,提出了国内商业银行应从5个方面改进信用卡业务的经营管理,具体包括更新经营理念、完善相关制度体系、培养专业人才、健全营销机制和提升服务品质.     

金融服务贸易自由化与主权意志的协调——基于对国家金融管理权的考察

WTO推动下的金融服务贸易自由化运动在增强全球金融服务贸易的活力的同时,也给国家金融管珲带来了冲击与挑战.在自由化承诺与义务的约束下,国家金融管理权的存废、冲突、协凋及行使方式,都是急需从国际法层面探索的课题.国际合作与主权意志表达方式的转换是实现金融服务贸易自由化与国家会融管理权良性运作的法治路径.