Puzzling out prioritiesBMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7164.959 (Published 10 October 1998) Cite this as: BMJ 1998;317:959
Why we must acknowledge that rationing is a political process
- Rudolf Klein, Senior associate.
- King's Fund, London W1M 0AN
Education and debate pp 1000-7
The second international conference on priorities in health care, held in London this week, is important for two reasons. Firstly, it provides a reminder that the phenomenon of rationing is indeed international and not just a byproduct of the way Britain's National Health Service is designed or funded. Countries with very different healthcare systems and levels of healthcare spending are all grappling with the problem of how to reconcile growing demands and constrained resources. Secondly, as the three conference papers published in this issue show (pp 1000-7),1–3 it marks recognition of the fact that priority setting is inevitably messy and difficult.4 The challenge everywhere is about how to organise and orchestrate what, for the foreseeable future, will be a continuing dialogue between politicians, professionals, and the public about the principles that should be invoked in making decisions about rationing and about how best to reconcile conflicting values and competing claims.