scholarly journals Priority Setting, Judicial Review, and Procedural Justice

2019 ◽  
pp. 185-196
Author(s):  
Daniel Wang ◽  
Benedict Rumbold
Keyword(s):  
Health Care ◽  
Procedural Justice ◽  
Priority Setting ◽  
Judicial Review ◽  
Procedural Fairness ◽  
Policy Decisions ◽  
Philosophical Literature ◽  
Accountability For Reasonableness

The justification for the judicial review of priority-setting decisions in the NHS is premised upon a distinction between substantive policy decisions and matters of procedural fairness, with courts themselves perceiving their function as restricted primarily to assessments of procedure. This approach finds normative ground in the ‘procedural turn’ in the philosophical literature on justice in health, in particular in the influential idea of ‘Accountability for Reasonableness’. However, this chapter will argue that relying on the substance/procedure distinction to identify the appropriate role for the courts in the control of allocative decisions in health care will attract to judicial review a series of concerns raised in the philosophical literature with regard to the idea of securing just priority setting through procedural means.

Implementing accountability for reasonableness – the case of pharmaceutical reimbursement in Sweden

2007 ◽  
Vol 2 (2) ◽  
pp. 153-171 ◽  
Author(s):  
SANDRA JANSSON
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Social Learning ◽  
Priority Setting ◽  
Relative Importance ◽  
Priority Setting Process ◽  
Structured Interviews ◽  
Accountability For Reasonableness ◽  
Setting Process ◽  
A Priority

AbstractThis paper aims to describe the priority-setting procedure for new original pharmaceuticals practiced by the Swedish Pharmaceutical Benefits Board (LFN), to analyse the outcome of the procedure in terms of decisions and the relative importance of ethical principles, and to examine the reactions of stakeholders. All the ‘principally important’ decisions made by the LFN during its first 33 months of operation were analysed. The study is theoretically anchored in the theory of fair and legitimate priority-setting procedures by Daniels and Sabin, and is based on public documents, media articles, and semi-structured interviews. Only nine cases resulted in a rejection of a subsidy by the LFN and 15 in a limited or conditional subsidy. Total rejections rather than limitations gave rise to actions by stakeholders. Primarily, the principle of cost-effectiveness was used when limiting/conditioning or totally rejecting a subsidy. This study suggests that implementing a priority-setting process that fulfils the conditions of accountability for reasonableness can result in a priority-setting process which is generally perceived as fair and legitimate by the major stakeholders and may increase social learning in terms of accepting the necessity of priority setting in health care. The principle of cost-effectiveness increased in importance when the demand for openness and transparency increased.

scholarly journals Accountability for Reasonableness, for Priority Setting and Resource Allocation: A Case Scenario

2015 ◽  
Vol 6 (2) ◽  
pp. 23-25 ◽  
Author(s):  
Zoheb Rafique
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Developing Country ◽  
Priority Setting ◽  
Case Scenario ◽  
Scarce Resources ◽  
Accountability For Reasonableness

The purpose of this paper is to discuss the accountability for reasonableness and its four conditions. This explains the priority setting and resource allocation for scarce resources. In this article it is discussed that how the scarce resources in a developing country like Pakistan be allocated in health care. This is explained with the help of case scenario.

Decentralized health care priority-setting in Tanzania: Evaluating against the accountability for reasonableness framework

2010 ◽  
Vol 71 (4) ◽  
pp. 751-759 ◽  
Author(s):  
Stephen Maluka ◽  
Peter Kamuzora ◽  
Miguel San Sebastiån ◽  
Jens Byskov ◽  
Øystein E. Olsen ◽  
...  
Keyword(s):  
Health Care ◽  
Priority Setting ◽  
Accountability For Reasonableness ◽  
Health Care Priority Setting

FROM WEDNESBURY UNREASONABLENESS TO ACCOUNTABILITY FOR REASONABLENESS

2017 ◽  
Vol 76 (3) ◽  
pp. 642-670 ◽  
Author(s):  
Daniel Wei L. Wang
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Social Policy ◽  
Health Service ◽  
Medical Treatment ◽  
Judicial Review ◽  
Accountability For Reasonableness ◽  
Health Authorities ◽  
Care Policies ◽  
Health Care Policies

AbstractOver the last decades, rationing of medical treatment in the National Health Service (NHS) has moved from implicit to being increasingly explicit about what is being denied and about the procedures and reasons for such decisions. This article argues that the courts have had an important role in this process. By applying a heightened scrutiny of rationing decisions, courts have forced health authorities to make better-informed decisions and to take procedural justice more seriously to comply with, respond to and avoid judicial review. The analysis in this article reveals that litigation has contributed to incremental, but significant and enduring, changes in a social policy. It also offers insights to the paradoxes of judicial accountability in health care policies.

Strategic Institutional Design: Two Case Studies of Non-Majoritarian Agencies in Health Care Priority-Setting

2014 ◽  
Vol 51 (4) ◽  
pp. 632-660 ◽  
Author(s):  
Claudia Landwehr ◽  
Katharina Böhm
Keyword(s):  
Health Care ◽  
Case Studies ◽  
Priority Setting ◽  
Institutional Design ◽  
Policy Decisions ◽  
Blame Avoidance ◽  
Health Care Priority Setting ◽  
Strategic Motives ◽  
Selection Of

Governments’ decisions to delegate policy decisions to non-majoritarian agencies have been both criticized as attempts at blame avoidance or depoliticization and defended as enhancing the rationality and credibility of decisions. This article focuses not on the decision to delegate, but on the decisions of how and to whom to delegate. We argue that strategic motives are relevant not only in the decision to delegate, but equally, and perhaps more importantly, in the selection of the institutional properties of these non-majoritarian agencies. We present two case studies of health care priority-setting, in England and Germany, to illustrate how governments proceed strategically in institutional design choices and how their decisions affect outcomes.

Moral ambivalence towards the Cancer Drugs Fund

2019 ◽  
Vol 45 (9) ◽  
pp. 623-626 ◽  
Author(s):  
Ilias Ektor Epanomeritakis
Keyword(s):  
Cancer Patient ◽  
Procedural Justice ◽  
Resource Distribution ◽  
Public Welfare ◽  
Cancer Drugs ◽  
Ethical Concerns ◽  
Accountability For Reasonableness ◽  
Present Essay ◽  
Moral Ambivalence ◽  
Robust Framework

The UK’s Cancer Drugs Fund (CDF) was introduced in 2010 following the Conservative Party’s promise to address the fact that numerous efficacious cancer drugs were not available because of their cost ineffectiveness, as deduced by the National Institute of Health and Care Excellence. While, at face value, this policy appears only to promote the UK’s public welfare, a deeper analysis reveals the ethically unjustifiable inconsistencies that the CDF introduces; where is the analogous fund for other equally severe diseases? Have the patients without cancer been neglected simply due to the fear-inducing advertising and particularly ferocious speech which surrounds cancer? The CDF is unjustifiable when challenged by such questions. However, it is troubling to think that the CDF might be repealed in order to abolish these ethical concerns. Intuitively, one feels uncomfortable stripping the cancer patient of their benefits just so that they might be on an equally pessimistic footing with others. In the present essay, I argue that, although there are no ethically justifiable grounds for the CDF’s introduction, its removal would be inappropriate. Following this realisation, I investigate whether the procedural steps of the CDF itself—theoretically removed from the context of resource distribution for all disease types—represent an ethically justifiable system. I believe that the answer is yes, given the CDF’s conformity to accountability for reasonableness, a robust framework of procedural justice, which continuously improves the ethical and epistemological standards of the policies to which it is applied.

Public participation in health care priority setting: A scoping review

Health Policy ◽  
2009 ◽  
Vol 91 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Craig Mitton ◽  
Neale Smith ◽  
Stuart Peacock ◽  
Brian Evoy ◽  
Julia Abelson
Keyword(s):  
Health Care ◽  
Public Participation ◽  
Scoping Review ◽  
Priority Setting ◽  
Health Care Priority Setting

scholarly journals Health Priority Setting in Iran: Evaluating Against the Social Values Framework

2016 ◽  
Vol 8 (10) ◽  
pp. 212
Author(s):  
Hakimeh Mostafavi ◽  
Arash Rashidian ◽  
Mohammad Arab ◽  
Mohammad R. V. Mahdavi ◽  
Kioomars Ashtarian
Keyword(s):  
Health Care ◽  
Health System ◽  
Priority Setting ◽  
Social Values ◽  
City Council ◽  
Decision Makers ◽  
The Public ◽  
Health Technologies ◽  
Health Priority ◽  
The Social

<p><strong>Background:</strong> Health systems, as part of the social system, consider public values. This study was conducted to examine the role of social values in the health priority setting in the Iranian health system.</p><p><strong>Methods:</strong> In this qualitative case study, three main data sources were used: literature, national documents, and key informants who were purposefully selected from health care organizations and other related institutions. Data was analyzed and interpreted using the Clark-Weale Framework.</p><p><strong>Results:</strong> According to our results, the public indirectly participates in decision-making. The public representatives participate in the meetings of the health priority setting as parliament members, representatives of some unions, members of the city council, and donors. The transparency of the decisions and the accountability of the decision makers are low. Decision makers only respond to complaints of the Audit Court and the Inspection Organization. Individual choice, although respected in hospitals and clinics, is limited in health care networks because of the referral system. Clinical effectiveness is considered in insurance companies and some hospitals. There are no technical abilities to determine the cost-effectiveness of health technologies; however, some international experiences are employed. Equity and solidarity are considered in different levels of the health system.</p><p><strong>Conclusion:</strong> Social values are considered in the health priority decisions in limited ways. It seems that the lack of an appropriate value-based framework for priority setting and also the lack of public participation are the major defects of the health system. It is recommended that health policymakers invite different groups of people and stakeholders for active involvement in health priority decisions. </p>

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