Describes and discusses the micro- and macro-political aspects of change in the NHS. Emphasizing the negotiation and power aspects of the change process in an environment of increasing constraint, the authors examine the key areas on the agenda for change.

Table of Contents

Introduction - innovation and interest in the organization of health care delivery; crisis and opportunity in health service management; professionals as gatekeepers - the role of doctors in the pharmaceutical value chain; accounting for patients? -information technology and the implementation of the NHS White Paper; time and the consultant - issues of contract and control; the future of primary care; nurse practitioners and the changing face of general practice; evolution in community care - the role of the community pharmacist; the diffusion of innovation in clinical equipment; modes of innovation in management information systems; innovation and the politics of patient information systems; hospitals in Britain - a history of design/innovation; reconstructing the future - the politics of designing a new hospital; central treatment - a case of smuggled innovation; the future of health care delivery; markets or hierarchies?.