1 April 1991
These trusts assumed responsibility for the ownership and management of hospitals, previously managed or provided by regional, district or special health authorities.
The government launched the Citizen's Charter to redefine the relationship between citizens and public service, seeking to set out the rights and entitlements of patients.
In 1992, the Conservative government introduced private finance initiatives (PFI). The main objective was to harness the private sector's efficiency, management and commercial expertise.
A total purchasing pilot (TPP) scheme was launched, allowing GPs in a locality to purchase all hospital and community health services for their patients.
The Health Committee published a report on purchasing, endorsing a separation between strategy and operational delivery as an approach to priority setting.
28 June 1995
The Act replaced regional health authorities, district health authorities and family health services authorities with regional NHS executive offices.
The government set out proposals to give primary care professionals greater flexibility to try different forms of contracting models.
Leglisation facilitated the piloting of different types of primary care contracting arrangements and established mechanisms for the direct employment of GPs.
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