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From voluntary to state control and the emergence of the department in UK hospital accounting

Robson, Neil


Neil Robson


This paper explores the development and diffusion of accounting techniques in UK hospitals and finds that attempts to utilise accounting data, for performance measurement and control, predate the introduction of the NHS in 1948. The main focus of the paper is the move from the uniform system of accounts, first introduced in 1893, to departmental accounting information in 1956. After identifying the antecedent accounting conditions the paper explores both why and how change occurred by analysing the roles of dominant individuals, institutions, political and economic forces that led to the introduction of departmental accounting. The process of change, after the nationalisation of the hospitals in 1948, had a significant impact on the accounting technology adopted: with departmental budgeting being dropped. Finally, the role of the medical profession in the departmentalisation debate is explored and possible explanations for the reluctance to adopt new management accounting techniques are discussed.


Robson, N. (2003). From voluntary to state control and the emergence of the department in UK hospital accounting. Accounting Business and Financial History, 13(2), 99-123.

Journal Article Type Review
Publication Date Jul 1, 2003
Journal Accounting, Business and Financial History
Print ISSN 0958-5206
Publisher Taylor and Francis
Peer Reviewed Peer Reviewed
Volume 13
Issue 2
Pages 99-123
Keywords hospital accounting, uniform accounts, voluntary, department, costing, budgets
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