Using Information on Variation in Rates of Supply to Question Professional Discretion in Public Services

18 Pages Posted: 15 Apr 2004

See all articles by Gwyn Bevan

Gwyn Bevan

London School of Economics & Political Science (LSE)

Sandra Hollinghurst

University of Bristol - Division of Primary Care

Peter Benton

Government of the United Kingdom - Office for National Statistics

Vicky Spark

NHS Information Authority - Casemix Programme

Hugh Sanderson

NHS Information Authority - Winchester and Eastleigh NHS Trust

Donald Franklin

Government of the United Kingdom - HM Treasury

Abstract

Governments face a formidable combination of principal/agent problems as third party payers for professional services. Health care is an exemplar of these difficulties. This paper develops the concept of discretionary services for acute hospitals from analysis of services with high variations in admission rates. It argues that this concept offers a way of challenging professional discretion and raising new kinds of questions over volumes and quality of services supplied. It illustrates the wider applicability of this concept with two examples: legal aid, and investigation of directors for fraud following bankruptcy.

Suggested Citation

Bevan, Gwyn and Hollinghurst, Sandra and Benton, Peter and Spark, Vicky and Sanderson, Hugh and Franklin, Donald, Using Information on Variation in Rates of Supply to Question Professional Discretion in Public Services. Available at SSRN: https://ssrn.com/abstract=513562

Gwyn Bevan (Contact Author)

London School of Economics & Political Science (LSE) ( email )

Houghton Street
London, WC2A 2AE
United Kingdom

Sandra Hollinghurst

University of Bristol - Division of Primary Care ( email )

Cotham House
Cotham Hill
Bristol, BS6 6JL
United Kingdom

Peter Benton

Government of the United Kingdom - Office for National Statistics

London, SW1A 2AA
United Kingdom

Vicky Spark

NHS Information Authority - Casemix Programme

London
United Kingdom

Hugh Sanderson

NHS Information Authority - Winchester and Eastleigh NHS Trust

London
United Kingdom

Donald Franklin

Government of the United Kingdom - HM Treasury

1 Horse Guards Road
London SW1A 2HQ, SW1
United Kingdom

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