ABSTRACT
This chapter describes the budgetary system in central government and is followed by a section on auditing, accountability and evaluation. It focuses on the systemic nature of budgeting, auditing and evaluation; intention is to identify what links are present current arrangements. The central idea was the creation of internal markets in health care: health authorities would buy services from hospitals and thus give patients greater choice and improve the quality of service. Hospitals would be allowed to become self-governing trusts and family doctors with large numbers of patients would hold their own budgets. Audit is one of the oldest and most firmly entrenched financial activities in government, not least because of its link with accountability, i.e., the holding of the government to account for the way it uses and disposes of public funds. Evaluation in the budgetary process is designed to serve the executive, is usually carried out internally and is structured to serve political goals.
