... accounting) within the healthcare setting. In this essay I will seek to examine the tensions and contradictions that arise between practitioners and policymakers in response to government's actions to limit accountability to the individual hospital. It will then be ascertained whether cost benefit analysis can provide a solution and unify the clinicians and the policymakers in a 'shared belief' in the legitimacy of the new accounting, which is essential to ensure the success of the reforms. The application of formal accounting procedures is a fairly recent phenomenon in the public sector and a direct result of the New Public Management reforms sweeping through Western economies. Since the 1970s there has been a building up of public and political opinion as to the lack of accountability by the public sector which appeared to be 'swallowing up' public funds and thereby placing a further burden on the economy. This led to calls for ...

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