Education And Debate

Rationing in general practice: Commentary: Commendable but confused

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7045.1533 (Published 15 June 1996) Cite this as: BMJ 1996;312:1533
  1. Peter Toon, senior lecturer in general practice, University of London TPMDE (petertoon@aol.com)a
  1. a 137 Roding Road, London E5 0DR

    In resource allocation, as in the courts, it is necessary not only that justice be done but also that it be seen to be done. The obscurity of how, why, and by whom rationing decisions are made in the NHS contrasts sadly with the openness of British courts.

    The purchaser-provider split made it possible for there to be greater clarity about how health care resources are allocated. It is surprising therefore that, despite widespread criticism of the ethical propriety of fundholding, fundholders have rarely published the principles that guide their actions. The Asbury practice's decision to do so is therefore to be welcomed.

    Macintyre argues …

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