ABSTRACT
This chapter is concerned with the issues of medical audit and clinical budgeting within the hospital sector of the United Kingdom National Health Service and the implications this may have for the medical autonomy of hospital doctors. In the United Kingdom, the medical profession, at least until recently, has been able to counter any threats to its professional autonomy. Yet, with the current moves away from a welfare state model of health care and towards a more market-driven one, it may be that the profession will now be finally incorporated into the service class in an organic role as opposed to the traditional one they have tended to play previously (Abercrombie and Urry 1983:147).1 If this is so, then the situation will be unique in Europe in adapting, as it does, the United States system characterized by Freddi (1989:13) as ‘market efficiency coupled with liberty’ as opposed to the ‘solidarity coupled with equality’ systems characteristic of Europe generally.
