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BMJ 1994; 308 doi: (Published 23 April 1994) Cite this as: BMJ 1994;308:1056
  1. R W Buckland

    Doctors in Britain may not have a burning interest in contracting, but their future depends on it. Contracting is now impinging on doctors' training and employment and may lead to departments or even whole units closing. Doctors can either allow serendipity to determine mechanisms for contracting or act to improve the process for the benefit of patients.

    In the everyday world of commerce customers buy products with clearly labelled prices and know exactly what they are getting for their money. But the health service is different. Until recently there has been no way of assigning costs to health care and prices have varied widely among hospitals. Purchasers hardly know what they want to buy and have no description of what they are buying. The block contract is …

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