In the
first year the budgets were set by Regional level managers, though some burden
would have fallen on the FHSAs as well. After the first year, FHSAs had to
negotiate the budget for fundholders, to hold the funds and make payments for
services purchased when directed by the fundholders, to monitor financial outcomes
and to check on the use to which fundholders put any budget surplus
Ž . Levitt et al., 1995 . The reforms would be expected to lead to a growth in the
administrative tasks.