ABSTRACT
The reports of the death of the internal market in the UK may be exaggerated with the evolutionary approach towards integrated care proposed within the new White Papers (DoH 1997; NHS Wales). Nonetheless, the time is ripe to explore the impact of the market, even in its highly managed form, on the ways in which services have been delivered. Moreover, this aids an understanding of the factors which shape both decision-making and change within the National Health Service, shedding light not only on market mechanisms but on the factors which shape changing patterns of service delivery within the NHS. This chapter explores how and why patterns of service delivery have changed, using the principality of Wales as a case study, and focuses particularly on the role of Health Authorities as the potential strategic drivers for change.
