Images of the contracting process

Abstract

In the past four years the Department of Health has produced a series of White Papers on the National Health Service which together constitute the most extensive set of changes since the creation of the service. This paper examines one of the those changes, the implementation of contracts for health, and reports on workshops undertaken by the authors and colleagues from the Health Services Management Unit. During these workshops contracts were negotiated for a variety of mental health services in localities across the Northern Regional Health Authority. Following a short introduction exploring the particular issues faced in contracting for mental health services, the paper sets out the four general aims of government policy contained in the White Papers. The article then introduces the methodology of the research before exploring how far the general aims of government policy are likely to be achieved by three distinct approaches to contracting identified at the workshops. These distinct approaches are characterised as the images of contracting held by managers and professional staff in late 1990/early 1991.