Contracts awarded to Nuffield Hospitals and Capio Healthcare UK to perform almost 25,000 hip, knee and other operations for NHS patients will help towards the target of reducing waiting times for operations to six months by 2005. The cost for each operation and associated care is on a par with equivalent NHS prices. Under the contracts around 880 NHS patients in each strategic health authority will start to receive operations within weeks, in 50 independent hospitals all over the country. The service will operate from 15 Capio and 35 Nuffield sites.All staff working on these contracts will be additional to the NHS and represent an increase in capacity. Many of the doctors and nurses will be trained staff who already work in independent hospitals in England. Additional staff will come from Sweden, Ireland and other parts of Europe. All will have to be fully licensed and subject to all required UK clinical standards.

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IT companies serving the local government market place have set up the Alliance of eGov Suppliers. Traditionally there has been no industry wide relationship with the local government sector as is the case in central government. The Office for Government Commerce has a Supplier Relations Team which fosters better working relationships and understanding between suppliers and central government. It includes specialists who are responsible for developing closer corporate relationships.The need for an industry-local government relationship first became apparent when the Office of the Deputy Prime Minister co-ordinated the development of the pathfinder projects. This was the first appearance of local government wide programmes. The need for a relationship framework became more acute when the National Projects, such as customer relationship management, were launched by the ODPM in 2003. The supplier community was keen to participate but unsure of how they could offer their products and enjoy the benefits.

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By Judith Smith and Kieran Walshe.The corporatization of primary care in the USA and the UK over recent years has transformed the way that these services are managed and delivered. Traditional approaches based around small practices of doctors and their teams as the primary organizational unit have been largely overtaken by new models in which doctors, nurses and other primary care professionals work within much larger organizations. This article explores the experience in the USA and the UK of seeking to organize primary care more corporately, and suggests that a tightly managed organizational model does not work well in primary care. Looser, network-based models are needed in which some of the benefits of corporatization can be achieved while the traditional small-organization virtues of primary care can continue to thrive.

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By Michael ChisholmReferenda will be held later in the year in three northern regions of England about the establishment of elected regional assemblies. If these are established, the areas with two-tier local government would be converted to unitary structures. The Government asserts that this would be necessary because the retention of the two tiers would be the retention of one tier too many, but offers no evidence to back up this assertion.

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