Health service finance

The introduction of an internal market for health services following the implementation of Working for Patients [1] has resulted in major changes in the roles of finance staff and the ways in which these staff work. Historically, the finance function was seen by those who delivered clinical services principally as a constraint. The role of the unit accountant was to account for expenditure, and to control it. This required certain technical skills, but did not require much knowledge of the nature of the services being delivered. This tended to result in finance staff being isolated from the delivery of patient services, and did not promote mutual understanding between clinicians and this part of the management team.