Contracts and quality of care.

What conditions should be included in contracts between hospitals and district health authorities to safeguard the quality of patient care? The white paper Working for Patients outlines (para 4.13) that "in future, each DHA's (District Health Authority) duty will be to buy the best service it can from its own hospitals, from other authorities' hospitals, from self governing hospitals, or from the private sector."' Hospitals for their part will have to satisfy districts that they are delivering the best and most efficient service. Working paper 2' expands these concepts and gives guidance on pricing block contracts, cost and volume, and cost per case contracts (paras 2.10 to 2.19). The only reference to quality of care in these contracts is in working paper 2 (para 2.20) that "it will be the How can referring general practitioners or hospital doctors be satisfied with patient care?