预算管理(英文原文与中文译文).doc

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1、英文原文Budgetmanagement1IntroductionTheNHSreformshavehadfarreachingimplicationsforcliniciansofallgradesandspecialties.Amongotherchanges,ithasbeendeliberategovernmentpolicythatseniorcliniciansshouldhavemoredirectmanagementandbudgetaryresponsibilitywithintheirownclinicalareas.Trusthospital

2、shavedevelopedadirectoratebasedmanagementstructureanddevolvedbudgetstoclinicaldirectors.A&Edepartmentshaveeitherbecomedirectoratesintheirownrightorassociatedirectorateswithinlargerdirectorates.A&Econsultantswhotakeonclinicaldirectorshipresponsibilitieswillhavemoredirectcontrolofspendi

3、ngwithintheirowndepartment.Atfirstthismayseemintimidating,buttheadvantagesofhavingcontroloutweighthedisadvantagesofmoreadministrativeactivity.Thisarticleaimstogivesomeguidelinestohelpmakethetasklessdaunting,aswellassometipsbasedonpersonalexperience.Idonotintendtocoverfundraisingactivi

4、tyortheorganizationofpostgraduateeducationanditsfunding.Briefmentionwillbemadeof"businessplanning"attheend.Andwehaveoutlinedwhatmanagementbudgetingisandhowitdiffersfromtraditionalbudgetarycontrolsystemsinhealthauthorities;consideredwhatitaimstoachieve;anddiscussedtheparticipationofcli

5、niciansinthemanagementbudgetingprocessanditslikelyimpactontheirmethodsofworking.2Whatisabudget?Traditionalbudgetarycontrolsystemsarebasedprimarilyonastructureofwhatarenormallytermedfunctionalordepartmentalbudgets.Inthisstructurebudgetsareheldbythosepeopleresponsibleforprovidingaservic

6、e.Thereisnormallynoparticipationofclinicalstaffinthisbudgetarycontrolstructureotherthanthepossibilitythatthebudgetholdersforpathologyandradiologymightbetheconsultantsincharge.Thisseemsstrangegiventheconsiderableinfluencethatclinicianshaveovertheuseofhospitalresources.Inanysystemofbudg

7、etarycontrolakeyprincipleisthatindividualbudgetholdersshouldbeheldresponsibleonlyforthoseitemsofexpenditureoverwhichtheycanexertcontrol.Inhealthauthoritiesthisprincipledoesnotalwaysapply.Anextremeexampleofthisconcernsthepharmacybudget,wherethepharmacistisoftenheldresponsiblefordrugsex

8、pendi