“…These mechanisms, and their impact on service delivery, have been the subject of debate in a number of countries, including Britain (Ravenscroft and Tolley, 1996), Northern Ireland (Knox and Young, 1995), the USA (Johnson, 1989), Canada (Glover and Burton, 1998) and many member states of the European Union (Johnson, 1989;Bramham, et al, 1993;and Muller, 1997). While recognizing the link between differing structures of provision and their respective impact on service delivery, it is clear that equal attention needs to be paid to assessing the relative effectiveness, ef ciency and economy of different structures of service provision.…”