BMA's replyBMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6968.1581 (Published 10 December 1994) Cite this as: BMJ 1994;309:1581
EDITOR,—P J N Howorth misses the point in two important respects. Firstly, the Health Policy and Economic Research Unit exists not only to promote and expand the BMA's policy but, more importantly, to stimulate debate by research into issues of health policy and thereby to allow the association and others to come to a considered view on these important matters. The paper on resource allocation formulas therefore seems to be succeeding in its stated aim of stimulating just such a debate and should not be censured for this reason.
Secondly, as the paper makes clear, the review of the Resource Allocation Working party formula in 1986 specifically included a factor for the regional Jarman score, which is an indirect measure of social deprivation based on several census variables. Despite the criticisms levelled at it there is no doubt that this score provides a measure of use of health services as measured by the perceived workload of general practitioners. This is presumably one of the factors underlying the disparity in the resources allocated to Blackpool and to Manchester quoted in Howorth's letter. This point is dealt with more fully in the briefing note. As the paper concludes, “there has been much criticism of the current weighted capitation formula.” Howorth's letter is further testimony to the truth of this statement. The Health Policy and Economic Research Unit's document is a valuable contribution in advancing this debate.