ABSTRACT

Southampton and South West Hampshire became a health commission in June 1992, merging the functions of the district health authorities and the Family Health Service Authority. Before describing the 1994 Purchasing Dilemmas exercise, it is worth reviewing the establishment of the purchasing function and its evolution into commissioning, using Southampton and South West Hampshire Health Commission as an example. The lessons learned from that exercise, together with the benefit of international experience, have been applied to the actual process of setting priorities. The exercise was preceded by a simulation seminar held in Southampton in 1991. This exercise was followed by the presentation of the views of four experts: an epidemiologist, a health economist, a moral philosopher and medical journalist. Lessons learned from the earlier simulation seminar were partly responsible for the large number of options in this exercise.