The effect of rules, habits and bureaucracies on costing in the UK National Health Service
- 2001
The widespread adoption and implentation of costing system in the UK National Heallth Service (NHS) has been an important part of the response to the structural changes brought about in the health sector over the last 20 years. One key feature of costing systms in this context is to provide a guide by which efficiency and effectiveness may be measured against a background of decision make in a public service environment where the public service provision ethos is important. Re-assesses the role of costing systems in the NHS in the light or research on rules and habit formation in the decision-making process. In developing theses points further argues that bureaucracies provide an important linkage in marshalling implict habitual behaviour to multiple-organisational goals. In so doing, bureaucratic structures represent part of the mechanism which falititate effective organisational performance. Such performance and provide signals for resource allocation via quasi-costs (or the internal quasi-tranfer prices), although the extent of the usefulness of such signals is questioned. In particular, argues that there is no connection between the market, such as it is , and intra-hospital resource allocations, at least not in a direct manner, nor in any manner in the short term
Custo Burocracia Regulamento National Health Service United Kingdom