Financial Control in the Public Sector

This chapter examines present and potential developments in financial control techniques for the public sector of the economy. The economic reality of limited resources is increasingly producing a sharper, more commercial approach to management in the public sector. The public sector covers an extremely wide field, but in order to narrow the discussion and give it a practical emphasis, the chapter concentrates primarily on the health service, especially performance evaluation and monitoring in that service. The manager within the health service faces certain dilemmas not suffered by a private sector counterpart. Public services, like any other form of economic activity, use up scarce resources which could have been used beneficially elsewhere. The health service, like the police and the education system, is faced by many competing and emotional demands on its finances. The clinician is determined to maximize care for individual patients; the manager’s perspective is to improve care for a specified population.