The abuse of regression in the National Health Service allocation formulae: response to the Department of Health's 2007 ‘resource allocation research paper’

2011 ◽  
Vol 174 (3) ◽  
pp. 517-528 ◽  
Author(s):  
Jane Galbraith ◽  
Mervyn Stone
Keyword(s):  
Resource Allocation ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Research Paper ◽  
Service Allocation

scholarly journals Resource Allocation for Equity in the British National Health Service, 1948–89: An Advocacy Coalition Analysis of the RAWP

2018 ◽  
Vol 43 (1) ◽  
pp. 69-108 ◽  
Author(s):  
Martin Gorsky ◽  
Gareth Millward
Keyword(s):  
Resource Allocation ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Allocative Efficiency ◽  
Working Party ◽  
Central State ◽  
Conceptual Approach ◽  
Advocacy Coalition ◽  
Founding Principle

AbstractBritain's National Health Service (NHS) is a universal, single-payer health system in which the central state has been instrumental in ensuring equity. This article investigates why from the 1970s a policy to achieve equal access for equal need was implemented. Despite the founding principle that the NHS should “universalize the best,” this was a controversial policy goal, implying substantial redistribution from London and the South and threatening established medical, political, and bureaucratic interests. Our conceptual approach draws on the advocacy coalition framework (ACF), which foregrounds the influence of research and ideas in the policy process. We first outline the spatial inequities that the NHS inherited, the work of the Resource Allocation Working Party (RAWP), and its new redistributive formula. We then introduce the ACF approach, analyzing the RAWP's prehistory and formation in advocacy coalition terms, focusing particularly on the rise of health economics. Our explanation emphasizes the consensual commitment to equity, which relegated conflict to more technical questions of application. The “buy-in” of midlevel bureaucrats was central to the RAWP's successful alignment of equity with allocative efficiency. We contrast this with the failure of advocacy for equity of health outcomes: here consensus over core beliefs and technical solutions proved elusive.

Resource Allocation in the National Health Service

1997 ◽  
Vol 23 (2-3) ◽  
pp. 291-318
Author(s):  
Christopher Newdick
Keyword(s):  
Resource Allocation ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Legal Framework ◽  
Allocation Of Resources ◽  
Standing Committee ◽  
The United Kingdom ◽  
Health Authorities ◽  
The Government

In the United Kingdom, how does the National Health Service (NHS or the Service) respond to the pressures imposed on it by patients, doctors and the government? What techniques for distributing resources have been adopted for managing these pressures? Part I of this Article explains the administrative evolution of the NHS. Part II discusses the legal framework surrounding the allocation of resources throughout the different tiers of the NHS: (1) from the Secretary of State for Health to health authorities, (2) from health authorities to hospitals and general practitioners (GPs), and (3) from doctors to patients. Part III comments on the case for a standing committee to advise the government on matters of resource allocation within the NHS. It also considers the legal, political, and managerial contributions to the debate and, in particular, comments on the future of the traditional notion of clinical freedom.Section A describes the culture that developed within the NHS, Section B discusses the pressure for reform that developed during the 1980s, and Section C reviews the system of the “internal market” for health that was introduced in 1990.

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