How to ensure high quality public services such as education and healthcare? The state spends huge budgets on providing health, education and social services, but the quality of services is still poor, the provision itself is ineffective, and access to them is unequal. In this book, Julian Le Grand argues that the best solution is to give choice to consumers and encouraging competition between service providers. He considers four ways of providing public services: trust; management by setting goals and evaluating results; voice; choice and competition. Based on his experience as a consultant to the British government, Le Grand argues that while all of these options have their merits, in most situations policies that focus on increasing choice and competition among service providers have the greatest potential for delivering high-quality, efficient , taking into account the interests of consumers and equal services. However, it is important that the relevant policies are designed correctly, and this book offers a detailed discussion of the main features that such policies should have in the context of health and education.