Health-care rationing dilemma in the UK

A new report says the British National Health Service should take a more open and honest approach to rationing health care. No matter how much resources are poured into the British National Health Service – which provides universal service available to everyone and essentially free at the point of use – rationing is inevitable, it says.

Health care rationing in national health systems can take the form of queuing, in which patients must wait for treatment, or limits on what treatments are made available, and who receives them.

The "Heathcare Funding Review" was a year-long examination of the health system by a group of patients, health professionals, and the private sector, including the pharmaceutical industry. Among its conclusions:

  • Treatments will increasingly be excluded from the NHS if they are of limited clinical effectiveness, not cost effective or an inappropriate use of public funds, says the report.

  • The concept of the NHS as a comprehensive service may now have outlived its usefulness.

  • Although public support for the principles of the NHS remains strong, confidence in its delivery is slipping.

    "The government and the public must decide how much money they are prepared to put into the NHS," says Ian Bogle, chairman of the steering group, who is also chairman of the British Medical Association, "and this will dictate the service that can be offered. But if people as individuals are not satisfied with this, we cannot and should not stop them going to the private sector. Although we see an expanded role for the private sector, we do not see tax relief on private medical insurance or other fiscal incentives."

    Source: Roger Dobson, Report urges more honest approach to rationing, British Medical Journal, February 10, 2001.

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