MIXED SIGNALS? PUBLIC SECTOR CHANGE AND THE PROPER CONDUCT OF PUBLIC BUSINESS

What begun after the 1979 General Election as an exercise to reduce the public sector's size and cost developed during the 1980s into continuous change to its organization, functions and structure. Throughout this process it appeared that certain assumptions were made about the presence and continuity of standards of conduct, the proper conduct of public business and the sense of public service. Such assumptions appear to have been based on a belief that these standards were general throughout the public sector and would be maintained or adapted during change. Little attention was given to what comprises the standards, how they are perceived and implemented across the public sector and who monitors or polices them, particularly in times of change. Various aspects of the changes, from devolved management to privatization, have brought a number of new pressures and perspectives on the conduct of public business which have led to cases involving failure to follow established procedures, the lack of expertise, conflict of interest, mismanagement, and misconduct. Together various cases have raised questions about dysfunctional consequences of change, the signals given to officials in terms of how change affects their functions, and the implications for the continued adherence to and effectiveness of both standards of conduct and of the means and procedures whereby probity and standards of conduct are maintained.     

THE INEXORABLE RISE IN THE UK NHS DRUGS BILL: RECENT POLICIES, FUTURE PROSPECTS

The UK National Health Service drugs bill has been the subject of controversy since the inception of the nhs . This article identifies the growth in the drugs bill and explores some of the factors driving the bill upward. The conclusions of this article are: that the drugs bill will continue to remain high on the political agenda; the government has only a limited amount of control on the drugs bill; various policies may counteract rather than complement each other; some of the policies may actually increase the drugs bill; however, many of the effects of the policies are unknown and there has been no rigorous assessment of the effects of any of the policies since 1948; and finally there is no robust evidence to suggest the drugs bill either does or does not represent good value for money.