Humphreys J
School of Post Compulsory Education and Training, University of Greenwich, London, England.
J Adv Nurs. 1996 Dec;24(6):1288-99. doi: 10.1111/j.1365-2648.1996.tb01037.x.
In 1995 the British National Health Service (NHS) Executive published details of a new framework for planning and commissioning education and training in the NHS. Among the central elements of these new arrangements are consortia of representatives from health care provider organizations and purchasing authorities among others, who will in due course take on responsibility for the commissioning of non-medical education and training (NMET). This NMET market is clearly distinct from the larger 'internal market' for health care provision by virtue of its separate funding, and different supply and demand side components. This paper includes an analysis of the new arrangements in terms of quasi-market theory and articulates a key role for consortia in harmonising the distinct markets for health services and NMET. A primary purpose of the paper is to examine the extent to which the new arrangements generally, and consortia in particular, can ensure that NMET contributes to NHS reform. Evidence from consortium development work in the South Thames Regional Health Authority, England, is discussed and it is argued that consortia will only perform effectively if they receive devolved real powers to an extent that persuades members to genuinely commit themselves to the proper development of consortia and the responsibilities of NMET commissioning. Finally a tendency to become preoccupied with education and training operations and processes rather than outputs is described and identified as a threat both to consortium effectiveness and educational innovation.
1995年，英国国家医疗服务体系（NHS）管理部门公布了一项新框架的详细内容，该框架用于规划和委托NHS内的教育与培训工作。这些新安排的核心要素包括来自医疗服务提供机构和采购部门等的代表组成的联盟，这些联盟将在适当的时候负责委托开展非医学教育与培训（NMET）。由于其独立的资金来源以及不同的供需方组成部分，这个NMET市场明显有别于规模更大的医疗服务“内部市场”。本文依据准市场理论对这些新安排进行了分析，并阐明了联盟在协调医疗服务和NMET这两个不同市场方面的关键作用。本文的一个主要目的是研究这些新安排，特别是联盟，在多大程度上能够确保NMET有助于NHS的改革。文中讨论了来自英格兰南泰晤士地区卫生局联盟发展工作的证据，并认为只有当联盟获得足够下放的实际权力，从而促使成员真正致力于联盟的妥善发展以及NMET委托工作的职责时，联盟才能有效运作。最后，文中描述并指出了一种倾向，即过于关注教育与培训的操作和流程而非产出，这对联盟的有效性和教育创新都构成了威胁。
