Any UK government is faced with a long list of health issues, this list would include macro questions such as the relationship of the National Health Service (NHS) to broader policies which might affect the health of the population and how to finance and staff health services. The NHS has gone through many stages of development in the last century, however the 1990 act introduced the most radical accounting control system since the birth of the NHS. Much accounting research has been developed on this topic and this paper will bring together some of their findings.

By the late 1980's general management in the NHS was in full force, and expectations of 'management discipline' were high, however there were a series of recurrent crisis. These crises were particularly evident in the hospital services and were caused by a combination of scarcity of compatible resources and an infinite demand for health care. Through a fundamental view of operations in 1989, two reviews were drawn up by the department of health, 'wor

Clatworthy, M. Mellett, H. (1997) Managing health and finance: Conflict or Congruence? Public Money and Management Oct-Dec pp 41-46

Llewellyn, S. (1993) Linking costs with quality in health and social care: new challenge for management accounting, Financial Accountability and Management, Vol 9 No 3, Aug 1993

Farnham, D. Horton, S. (1995) Managing the new public services (3rd edn) (Macmillan Press Ltd)

Arguably the views on the adoption of management control systems in the public sector depends on our position in society. As our society is more focused on markets, competitiveness and efficiency, it is likely that accounting techniques will play an important role, however, the importance of keeping the welfare of our society should be first and foremost. After all the goals of public sector organisations should differ from those in the private sector (e.g. they should not be profit maximisers). The objective of the NHS as an organisation remains unchanged since the reforms, in terms of securing an improvement in the state of the health of the population. However, it is now faced with the dilemma, that the means of achieving this greater improvement has been surfaced with financial considerations (Mellett 1998).

Some common words found in the essay are:
Care Act, National Income, Population Trends, NHS Due, Pugh Hichson, Service NHS, public sector, private sector, Prentice Hall, Society Humphrey, Management Apr-Jun, Coombs RW, sector management, health service, national health service, health care, flynn 1993, internal market, et al, accountable management, national health, care act 1990, et al 1997, community care act, nhs community care,
Approximate Word count = 2731
Approximate Pages = 11 (250 words per page double spaced)