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" Contextual history of accounting in UK hospitals : "
Robson, Neil
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Latin Dissertation
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| Record Number
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1099781
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TLets583858
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| Main Entry
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Robson, Neil
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| Title & Author
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Contextual history of accounting in UK hospitals :\ Robson, Neil
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| College
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Cardiff University
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| Date
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2006
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| student score
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2006
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| Degree
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Ph.D.
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| Abstract
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This thesis explores accounting change in UK hospitals, from 1880 to 1974. Using a processual approach (Porter, 1981 Pettigrew, 1987 Bhimani, 1993 Dawson, 2003) to historical investigation the focus is on three accounting 'events': the introduction of Burdett's uniform system of accounts in 1893 the introduction of annual departmental costing in 1956, and the introduction of functional budgeting in 1974. There is a duality to the research which explores both the role of change agents and the contextual environment within which change takes place. For the first event, contextual factors such as the growth in hospital care, early 'managerialism' and moral concerns are first explored. These are identified as important in stimulating interest in accounting change, from both internal and external groups and institutions, but it is internal groups that take control of accounting reform. It is argued that economic, professional and technological forces were crucial in the spread of these accounts. The second event takes place after the nationalisation of voluntary hospitals in 1948 with an emphasis on the process of change after nationalisation. The interaction of dominant individuals, groups and institutions, as well as political and economic forces are all explored in an effort to explain the how and why of change. The role of the medical profession in the departmentalisation debate is discussed, together with possible explanations for the reluctance to adopt new management accounting techniques. The final event was preceded by a renewed interest in the concept of efficiency (Klein, 1995) and the thesis examines a number of managerial initiatives between 1956 and 1974. It suggests that there was a cautious approach to change among both accounting practitioners and civil servants and this, together with a disappointing response to previous accounting reform, combines to prevent more radical accounting change. The thesis adds to the limited information on public sector accounting and suggests that the controversies surrounding the introduction, and use, of 'new' accounting technologies are part of a long process which can be traced back to the pre-nationalised voluntary hospitals and constitute a recurring theme throughout the life of the NHS.
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Cardiff University
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