Purchasers and Providers: The Impact of the NHS Reforms on Medical Schools

The introduction of the National Health Service (NHS) reforms, and more particularly of an internal market for the provision of health care to local populations, is continuing to impact on medical education and research in ways that create considerable challenges for university managers. The lack of an overarching framework of principles at national level means that they are having to negotiate outcomes and develop solutions to problems locally, with no guarantee of consistency across the country. Moreover, the market is not a totally free market, but subject to Government intervention when this is considered politically expedient. University managers'efforts to safeguard the interests of medical education nationally and institutionally may have salutary lessons for other areas of university activity, and provide an indication of future trends.