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Inequlity, the National Health Service and Health Policy*

Published online by Cambridge University Press:  28 November 2008

Alan Maynard
Affiliation:
Department of Economics and Related Studies, University of York
Anne Ludbrook
Affiliation:
Grampian Health Board, Aberdeen, Scotland

Abstract

The National Health Service (NHS) was founded in 1948 to replace an inefficient, ill-coordinated and financially unstable health care system and to reduce the barriers to the consumption of health care. In this article, it is argued that the geographic and social class equity objectives of the NHS have been poorly specified and that attempts to achieve them through government policy have been inadequate. The renewed interest in inequalities in health and health care and the problems of formulating and implementing policies aimed at reducing inequalities are discussed in general terms in section 1. Section 2 examines the inequalities of health care provision that were inherited in 1948, the development of policies to mitigate the problem and the current situation. Alternative demand and supply side policies to reduce inequalities in health and health care are presented in section 3. A summary of the proceeding arguments is set out in section 4.

Type
Articles
Copyright
Copyright © Cambridge University Press 1982

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References

REFERENCES

Abel-Smith, B. (1978) National Health Service: The First 30 Tears, London: HMSO.Google Scholar
Brotherston, J. (1976) Inequality, is it Inevitable? In C. O. Carter, and J. Peel, Equalities and Inequalities in Health, London: Academic Press.Google Scholar
Burchell, A. (1981) Inequalities in Health: An Analysis of the 1976 General Household Survey. Government Economic Service Working Paper No. 49.Google Scholar
Collins, E. and Klein, R. (1980) Equity and the NHS: self-reported morbidity, access and primary care, British Medical Journal, 281, 1111–15.Google Scholar
Department of Health and Social Security (1975) Regional Resource Allocation Formula: First Interim Report of the Resource Allocation Working Party, London: HMSO.Google Scholar
Department of Health and Social Security (1976) Sharing Resources for Health in England: Report of the Resource Allocation Working Party. London: HMSO.Google Scholar
Department of Health and Social Security (1979) Working Party on Under-doctored Areas. London: DHSS.Google Scholar
Department of Health and Social Security (1980a) Health and Personal Social Services Statistics 1978. London: HMSO.Google Scholar
Department of Health and Social Security (1980b) Inequalities in Health: Report of a Research Working Group. London: DHSS.Google Scholar
Eckstein, H. (1958) The English Health Service, Cambridge, Mass., Harvard University Press.Google Scholar
Foot, M. (1973) Aneurin Bevan: A Biography. Volume Two 1945–1960. London: Davis-Poynter.Google Scholar
Gray, A. (1981) On the Black Report: Inequalities in Health, a summary and comment. Northern Health Economics Publication, University of Aberdeen.Google Scholar
Grossman, M. (1972) The Demand for Health: A Theoretical and Empirical Investigation. New York: National Bureau of Economic Research.Google Scholar
Lancet (1981) Commentary from Westminster: Mr. Jenkin on the Black Report, i, 735–6.Google Scholar
Le Grand, J. (1978) The Distribution of Public Expenditure: The Case of Health Care, Economica, 45, 125–42.CrossRefGoogle Scholar
Maynard, A. and Ludbrook, A. (1980) Budget allocation in the National Health Service, Journal of Social Policy, 9, 289312.Google Scholar
Maynard, A. (1981) The inequalities and inefficiency of health care systems in Western Europe, Social Policy and Administration, July.Google Scholar
Ministry of Health (1920) Interim Report on the Future Provision of Medical and Allied Services (Dawson report), Cmd 693. London: HMSO.Google Scholar
Ministry of Health (1944) A National Health Service, Cmd 6502. London: HMSO.Google Scholar
Ministry of Health (1946) The National Health Service Bill: A Summary of the Proposed Service, Cmd 6761. London: HMSO.Google Scholar
Ministry of Health (1962) A Hospital Plan for England and Wales, Cmnd 1604. London: HMSO.Google Scholar
Ministry of Health (1966) The Hospital Building Programme: A Revision of the Hospital Plan for England and Wales, Cmnd 3000. London: HMSO.Google Scholar
Ministry of Health (1967) Annual Report for the Year 1966, Cmnd 3326. London: HMSO.Google Scholar
Morris, J.N. (1979) Social inequalities undiminished, Lancet, I, 8790.CrossRefGoogle Scholar
Muurinen, J.M. (1981) Inequalities in Health: an economic interpretation, Department of Economics, University of York, mimeograph.Google Scholar
Newhouse, J.P. and Friedlander, L.J., (1980) The relationship between medical resources and measures of health: some additional evidence, Journal of Human Resources, 15, 200–18.CrossRefGoogle ScholarPubMed
Office of Population Censuses and Survey, (1978), Occupational Mortality: Registrar General's Decennial Supplement for England and Wales 1970–2. London: HMSO.Google Scholar
Office of Population Censuses and Surveys (1980) Mortality Statistics by Area 1978. London: HMSO.Google Scholar
Rein, M. (1969) Social class and the utilisation of medical care services, Hospitals, 43, 1 07, 4352.Google Scholar
Report of the Committee of Enquiry into the Cost of the National Health Service, (1956) Cmd 9663. London. HMSO.Google Scholar
Royal College of General Practitioners (1981) A Survey of Primary Care in London. Occasional Paper 16. London: Royal College of General Practitioners.Google Scholar
Socialist Medical Association (1933) A Socialized Medical Service. London: Socialist Medical Association.Google Scholar
Stevens, R. (1966) Medical Practice in Modern England. New Haven: Yale University Press.Google Scholar
Townsend, P. (1974) Inequality and the health service, Lancet, 1, 1179–90.CrossRefGoogle ScholarPubMed
West, P. A. (1973) Allocation and equity in the public sector: the hospital revenue allocation formula, Applied Economics, 5(3) 153–66.Google Scholar