Intended for healthcare professionals


Choice and equity: lessons from long term care

BMJ 2004; 328 doi: (Published 10 June 2004) Cite this as: BMJ 2004;328:1389
  1. Christopher Deeming, research fellow (,
  2. Justin Keen, professor of health politics (
  1. Department of Public Health Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT
  2. Nuffield Institute for Health, University of Leeds, Leeds LS2

    Government prefers greater equity of finance to equity of access

    On the face of it, recent statements about the equation of choice with equity in the NHS and social care seem to strengthen the government's commitment to care services that are both fair and responsive.1 Few would oppose increased choice for consumers of public services as a general principle. The United Kingdom, when judged overall, has long had one of the most equitable healthcare systems among developed countries. Inequalities in healthcare provision and the health status of the population have, however, always been marked,2 and improvement in equity has always been an important policy objective.3 The government is now arguing that patients should be given more choice about how their own health care is managed and that this managed choice will help to drive up quality in the new, fixed price, internal market. …

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