Abstract
The creation of an internal market in the NHS appeared to place explicit rationing on the agenda of healthcare providers. Rationing had always occurred within the service but previously it had been camouflaged under clinical judgment. Now purchasers were to draw up plans showing how much was to be allocated to what type of care and why. Providers were to audit clinical staff to ensure that their work conformed to agreed criteria of effectiveness and all was to be open to public scrutiny.