Traces the origins of the fashion for quality assurance and discusses the requisites of a quality assurance strategy. On the basis of a Department of Health funded study in England and Wales in 1989, draws attention to the wide range of activities which have been swept into the Quality Assurance net, the striking differences between the factors cited as constraining or facilitating the development of quality assurance, and the abysmal lack of data on cost of resources or to any systematic monitoring and evaluation. Suggests that the purchaser‐provider split may have worsened the situation.
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