The Resource Management Initiative (RMI) is a central ingredient in plans to instil market‐based relationships in health care and medicine. However, these plans have not benefited from any adequate assessment of “resource management”. Demonstrates how earlier experience with resource management provides little guidance as to how it might be made to work. While resource management implies that measures of cost and activity were to be related to each other, its purposes are confused and confusing. While seemingly offering a variety of advantages, resource management is characterized by struggles and negotiations over its operational substance. Moreover, the initiative failed to resolve crucial issues over how to account for activities. Experience of tackling these issues as market‐based relationships came into effect during 1992‐3 demonstrates that resource management provides limited assistance to managers of the service.
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