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“Comparing the incomparable”: Hospital costing and the art of medicine in post-war Britain

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  • Gebreiter, Florian

Abstract

This paper examines the relationship between medical and hospital accounting discourses during the two decades after the 1946 National Health Service (NHS) Act for England and Wales. It argues that the departmental costing system introduced into the NHS in 1957 was concerned with the administrative aspects of hospital costliness as contemporary hospital accountants suggested that the perceived incomparability, immeasurability and uncontrollability of medical practice precluded the application of cost accounting to the clinical functions of hospitals. The paper links these suggestions to medical discourses which portrayed the practice of medicine as an intuitive and experience-based art and argues that post-war conceptions of clinical medicine represented this domain in a manner that was neither susceptible to the calculations of cost accountants nor to calculating and normalising intervention more generally. The paper concludes by suggesting that a closer engagement with medical discourses may enhance our understanding of historical as well as present day attempts to make medicine calculable.

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  • Gebreiter, Florian, 2016. "“Comparing the incomparable”: Hospital costing and the art of medicine in post-war Britain," The British Accounting Review, Elsevier, vol. 48(2), pages 257-268.
    • Handle: RePEc:eee:bracre:v:48:y:2016:i:2:p:257-268
    DOI: 10.1016/j.bar.2015.01.002
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    1. Mueller, F. & Carter, C., 2007. "`We are all managers now': Managerialism and professional engineering in UK electricity utilities," Accounting, Organizations and Society, Elsevier, vol. 32(1-2), pages 181-195.
    2. Barreiros, Lídia., 1985. "Towards social accounting," ILO Working Papers 992431063402676, International Labour Organization.
    3. Dent, Jeremy F., 1991. "Accounting and organizational cultures: A field study of the emergence of a new organizational reality," Accounting, Organizations and Society, Elsevier, vol. 16(8), pages 705-732.
    4. Samuel, Sajay & Dirsmith, Mark W. & McElroy, Barbara, 2005. "Monetized medicine: from the physical to the fiscal," Accounting, Organizations and Society, Elsevier, vol. 30(3), pages 249-278, April.
    5. Kurunmaki, Liisa, 2004. "A hybrid profession--the acquisition of management accounting expertise by medical professionals," Accounting, Organizations and Society, Elsevier, vol. 29(3-4), pages 327-347.
    6. Jeffrey E. Harris, 1977. "The Internal Organization of Hospitals: Some Economic Implications," Bell Journal of Economics, The RAND Corporation, vol. 8(2), pages 467-482, Autumn.
    7. Chua, Wai-Fong & Degeling, Pieter, 1993. "Interrogating an accounting-based intervention on three axes: Instrumental, moral and aesthetic," Accounting, Organizations and Society, Elsevier, vol. 18(4), pages 291-318, May.
    8. Miller, Peter & O'Leary, Ted, 1987. "Accounting and the construction of the governable person," Accounting, Organizations and Society, Elsevier, vol. 12(3), pages 235-265, April.
    9. Jane Broadbent & James Guthrie, 2008. "Public sector to public services: 20 years of “contextual” accounting research," Accounting, Auditing & Accountability Journal, Emerald Group Publishing Limited, vol. 21(2), pages 129-169, February.
    10. Neil Robson, 2007. "Adapting not Adopting: 1958 - 74. Accounting and Managerial 'Reform' in the Early NHS," Accounting History Review, Taylor & Francis Journals, vol. 17(3), pages 445-467.
    11. Preston, Alistair M., 1992. "The birth of clinical accounting: A study of the emergence and transformations of discourses on costs and practices of accounting in U.S. hospitals," Accounting, Organizations and Society, Elsevier, vol. 17(1), pages 63-100, January.
    12. Llewellyn, Sue & Northcott, Deryl, 2005. "The average hospital," Accounting, Organizations and Society, Elsevier, vol. 30(6), pages 555-583, August.
    13. Preston, Alistair M. & Cooper, David J. & Coombs, Rod W., 1992. "Fabricating budgets: A study of the production of management budgeting in the national health service," Accounting, Organizations and Society, Elsevier, vol. 17(6), pages 561-593, August.
    14. Miller, Peter, 1991. "Accounting innovation beyond the enterprise: Problematizing investment decisions and programming economic growth in the U.K. in the 1960s," Accounting, Organizations and Society, Elsevier, vol. 16(8), pages 733-762.
    15. William J. Jackson, 2012. "‘The collector will call’: controlling philanthropy through the annual reports of the Royal Infirmary of Edinburgh, 1837--1856," Accounting History Review, Taylor & Francis Journals, vol. 22(1), pages 47-72, March.
    16. Ogden, S. G., 1995. "Transforming frameworks of accountability: The case of water privatization," Accounting, Organizations and Society, Elsevier, vol. 20(2-3), pages 193-218.
    17. Chua, Wai Fong, 1995. "Experts, networks and inscriptions in the fabrication of accounting images: A story of the representation of three public hospitals," Accounting, Organizations and Society, Elsevier, vol. 20(2-3), pages 111-145.
    18. Neil Robson, 2003. "From voluntary to state control and the emergence of the department in UK hospital accounting," Accounting History Review, Taylor & Francis Journals, vol. 13(2), pages 99-123.
    19. Andy Holden & Warwick Funnell & David Oldroyd, 2009. "Accounting and the moral economy of illness in Victorian England: the Newcastle Infirmary," Accounting, Auditing & Accountability Journal, Emerald Group Publishing Limited, vol. 22(4), pages 525-552, May.
    20. Burchell, Stuart & Clubb, Colin & Hopwood, Anthony G., 1985. "Accounting in its social context: Towards a history of value added in the United Kingdom," Accounting, Organizations and Society, Elsevier, vol. 10(4), pages 381-413, October.
    21. Neil Robson, 2006. "The road to uniformity: accounting change in UK voluntary hospitals," Accounting and Business Research, Taylor & Francis Journals, vol. 36(4), pages 271-288.
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