GLENNERSTER, Howard <br/><br/>
La contractualisation au sein du service national de santé au Royaume-Uni 

 - Paris :  IIAP,  oct./déc. 1995 
<br/><br/> The National Health Service (NHS) in the United Kingdom underwent an important reform in 1991. This huge transformation allowed an improvement in transparency of NHS activities and the highlighting of preoccupations concerning profitability and quality. Nevertheless the desired separation between the purchasers of health care services and the providers of these services, and the introduction of a policy of contractualisation between the two sets of actors has not brought about satisfactory results. In fact obstacles to change remain numerous and have become particularly apparent with regard to the uncertain legal status of the contracts, the as yet insufficient competition between the different actors involved and a certain lack of motivation amongst the district health-authorities over whom no-one exercises control