The present governmental reforms of the National Health Service are the most far-reaching to date and have fundamental implications for health professionals. The focus of this article is to raise some of these issues in relation to occupational therapy. The introduction of trusts, the purchaser/provider split and the internal market are some of the mechanisms by which the government hoped to tackle the funding crisis of the late 1980s. These reforms have been operating since 1991, but little has been published on the impact of the self-governing trust movement on occupational therapy. Some observations on and an evaluation of these reforms are offered. It is hoped that the article will stimulate discussion within the profession about the role of trusts and their relationship to the delivery and development of an occupational therapy service.
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