The implementation of the NHS and Community Care Act, the greatly
increased use of voluntary sector providers and the switch from grants
to
contracts form the background to this study. The article brings together
two main themes in current social policy debate in the personal social
services: regulation and quality assurance. Contracts are seen as increasingly
significant forms of input, process and output regulation, although
their impact depends upon their type and specificity and upon the capacity
of purchasers to monitor contract compliance, and the sanctions
available to them. Clarification of the conceptual framework is followed
by the report of an empirical study of the position in a single large county.
The results from this study are then discussed in the context of evidence
from other parts of Britain and the United States. The main issues
identified in this discussion are competition, consumer choice, user
involvement, the dangers of excessive and inappropriate regulation, the
importance of trust and risk, and the relationship of resources to quality.