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The purpose of this paper is, for English acute NHS hospitals, to investigate how they operate their governance systems in the area of secondary care contracting and identify the key determinants of relationship building within the contacting/commissioning of secondary care focusing upon non‐price competitive behaviour.

A survey instrument was designed and mailed to a sample of all acute NHS hospitals in England of whom 35 per cent responded. This survey was then analysed using logit techniques.

The analysis suggests that: those NHS Trusts offering volume discounts, non‐price competitive incentives or having a strong belief in performance being by “payment by results” criteria are significantly more likely to offer augmented services to secondary care purchasers over and above contractual minima; those NHS Trusts strongly believing in the importance of non‐price factors (such as contract augmentation or quality) in the contracting process are more likely to offer customisation of generic services; and those NHS Trusts using cost‐sharing agreements to realign contracts when negotiating contracts or who strongly believe in the importance of service augmentation in strengthening relationships, or that increased hospital efficiency is the most important aspect of recent NHS reform are more likely to utilise default measures to help realign contracts.

This paper fills a gap in the area of non‐price competition in English NHS acute secondary care contracting.

The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides:

Elie Halévy essentially expressed the view recorded by James Mill in his anonymously written ‘On the Nature, Measures, and Causes of Value’⁷ that the first chapter of the Critical Dissertation relating to the nature of value ‘contains not an assertion, who which, as far as ideas politico-economical are concerned, Mr. Ricardo would not have assented; it contains, not indeed, as far as such ideas are concerned, an assertion which is not implied in the propositions which Mr. Ricardo has put forth. It is a criticism on some of Mr. Ricardo's forms of expression…’ ([J. Mill], 1826a, p. 157). The justification for the Ricardian reaction is clear enough, as I shall now show.⁸

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.

In 1899 the medical practitioners of Dublin were confronted with an outbreak of a peculiar and obscure illness, characterised by symptoms which were very unusual. For want of a better explanation, the disorder, which seemed to be epidemic, was explained by the simple expedient of finding a name for it. It was labelled as “beri‐beri,” a tropical disease with very much the same clinical and pathological features as those observed at Dublin. Papers were read before certain societies, and then as the cases gradually diminished in number, the subject lost interest and was dropped.

INTRODUCTION During the past dozen years a relatively large theoretical literature has grown out of the models proposed by Averch‐Johnson (2) and, to a lesser extent, Wellisz (90). Averch‐Johnson (here‐after A‐J) pointed out the now famous overcapitalization effect‐that a monopoly subject to rate of return regulation has an incentive to use more than the cost minimizing value of capital. The A‐J model was at first regarded as simply a theoretical explanation of what was long thought to be a significant cost of regulation. After languishing in this state for several years, the model achieved some popularity as a vehicle for theoretical explorations of various aspects of rate regulation. To date, the A‐J model has given rise to nearly forty papers on what has come to be called “the theory of regulatory constraint.”

Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐17; Journal of Property Investment & Finance Volumes 8‐17; Property Management Volumes 8‐17; Structural Survey Volumes 8‐17.