This historical reflection traces the changes in accounting practice in UK hospitals, focussing on costing, funding and budgetary control. The paper finds that, contrary to many implicit assumptions in academic accounting studies, our accounting ancestors promoted, and sometimes used, accounting data in pursuit of similar objectives to those advocated in the 21st century. For example, cost comparison information, often prepared with the aim of rewarding 'efficient' hospitals, is a particular feature of accounting practice throughout the last hundred years. This cost information 'evolved', within its historical context, although the process of establishing standard costs was slow and controversial, and the use of such information for funding hospital activity was avoided. The paper also argues that information for control, particularly budgetary control, was central to the nationalised service, and achieved its primary aim of limiting expenditure (Lapsley, 2001a). Finally it is suggested that the devolution of financial control to lower level managers, was a slow but significant process often overlooked in the accounting literature.
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