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Considerable changes are taking place in the delivery of public services throughout the western world. In health care systems,the issues that arise in accountability and choice are in many ways a manifestation of the inherent and complex network of relationships. Given their different constitutional and organisational backgrounds, the book explores whether there is any ground for reform, what mistakes are being made and what they can learn from one another. The book compares and contrasts the changes currently being made to the organisation and delivery of health care in the UK, New Zealand and Canada, particularly from the perspective of public accountability and choice.