Equity in the NHS Allocating resources for health and social care in England

Abstract

The fair allocation of resources for health and social care in relation to the needs of the population in different parts of the United Kingdom has become particularly important since the implementation of the new arrangements for community care in April 1993. These depend on close collaboration between health authorities and local authority social services departments. Yet funding reaches these authorities by different means and according to different criteria. Most health authority funds come through a weighted capitation formula that overemphasises the effects of age, while family health services funding is largely not cash limited and hence demand led. Funds to local authorities for community care are being transferred from the social security budget but on a basis that partly reflects past provision of residential and nursing home care. None of these mechanisms responds to underlying needs that give rise to demands on the health and social care system as a whole, and none makes any attempt to compensate for defects in the others. The solution includes better research and a unified weighted capitation system for all sources of funding.

Material versus social deprivation and health: a case study of an urban area

“…Consequently, indexes for small areas should identify an ''environmental'' component underlying social differences as a proxy for unknown individual characteristics. This implies that, according to equity considerations, more deprived areas should require a larger amount of resources [24][25][26].…”

Commentary: The basis of a more rational method of funding primary medical care?

“…The main benefit of the work is that it is a major step towards the development of a more rational method of funding primary medical care services. These services have traditionally been funded on the basis of previous spending both at health commission level and general practice level, and this has led to inequities in funding 1 2. As a result of this study, the socioeconomic determinants of consultation rates in general practice are now much clearer.…”

Equity in health care

“…EDITOR, - E S Williams and C M Scott comment on our review of some of the weaknesses of the current methods of allocating resources to NHS regions 1. They argue that the age-cost weights in the current formula assume, in their view wrongly, that all elderly people have the same health needs2 and that we should have made this point in our paper.…”