BMJ 1995;311:264 (22 July)

Letters

Medical profession should develop consensus on health priorities via debates

EDITOR,--I wish to suggest a way forward with regard to rationing.1 I have had professional experience of rationing with extracontractual referrals,2 and it seems invidious to make medical professionals responsible for local rationing in a national health service. Medical practitioners have an opportunity to take the lead in the debate on rationing in the absence of leadership by the government, and we should begin by using the emerging consensus on medicine's core values3 linked to a reaffirmation of the principle of the NHS. The next stage would be to examine current activities using a systematic methodology--for example, marginal analysis.4

The medical profession is being encouraged to discuss with patients and populations its professional judgments. We should take the opening offered by these demands for discussions to encourage vociferous local debates through the regional machinery of the BMA. In practice this would mean clinicians, clinical directors, and medical directors of NHS . . . [Full text of this article]


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