Go to The Economics of Health Care
Unit 1. The problems of health care Page 10
1
 vii. Approaches to rationing
It has been increasingly accepted at both local and national level in the UK that rationing is inevitable in the NHS. This has led to initiatives to explore the best way of making such decisions. One approach has been to use surveys of randomly sampled adults. One such survey carried out in Great Britain in 1995/6 generated a 75% response rate and most of the people surveyed thought that surveys like this should be used in the planning of health services. The list below shows how this sample thought health care services should be prioritised.
 
 
Priority rating of health services
  1. Treatments for children with life-threatening illnesses
  2. Special care and pain relief for people who are dying
  3. Preventive screening services and immunisations
  4. Surgery such as hip replacements to help people carry out everyday tasks
  5. District nursing and community services/care at home
  6. Psychiatric services for people with mental illnesses
  7. High technology surgery, organ transplants and procedures which treat life threatening conditions
  8. Health promotion / education services to help people lead healthy lives
  9. Intensive care for premature babies who weigh less than 680g with only a slight chance of survival
  10. Long stay hospital care for elderly people
  11. Treatment for infertility
  12. Treatment for people aged 75 and over with life threatening illness
Citizens' juries

The case of Jaymee Bowen (Child B) outlined in the previous section, made the issue of health care rationing in the UK headline news. Cambridge and Huntingdon Health Authority responded to this 'trial by tabloid' by setting up a citizens' jury to help decide health care prioritisation. Sixteen 'jurors' sat for four days hearing advice from expert witnesses. They were asked to consider how priorities for health care should be set, according to what criteria and to what extent the public should be involved. Most thought that there should be an element of public involvement in developing rationing guidelines, but only alongside other interests. Nobody voted for the involvement of politicians in a national council for priority setting.

One option is to 'let the market decide'. This is explored in Unit 2 'The free market approach to health care'.

Now look at these (check the status bar for information)

i. Approaching the problems
2. The free market approach to health care
5. Health care - further questions

Question Answer
According to the survey, which of these groups should be given more priority?

A. Old people
B. Young people

 
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