Strategic purchasing is a central function for improving health systems performance. Countries are increasingly moving away from passive purchasing arrangements towards strategic forms of purchasing. Part One of this book contains an overview of purchasing arrangements in the European Region, together with an assessment of the performance of different purchasing models in terms of health gain, efficiency, equity, responsiveness and accountability. Part Two has detailed chapters on the theories of purchasing; the role of purchaser and provider markets; consumer participation in purchasing decisions; defining public health objectives; the government's stewardship role; purchaser-provider contracts; financial incentives; the role of provider organisations; clinical governance and purchasing for quality of care.