Intended for healthcare professionals

Observations Body Politic

Allocation of NHS resources: are some patients more equal than others?

BMJ 2012; 344 doi: (Published 15 May 2012) Cite this as: BMJ 2012;344:e3362
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}

When it comes to determining health need, age counts for something, but other factors usually count for more

Age is what really determines health need, the health secretary for England believes. When the new clinical commissioning groups are up and running, areas with lots of old people will no longer be penalised by the way the NHS allocates resources, he promised in a speech last month.1 This is the kind of thing you expect a Conservative minister to say, since the current formula favours young but deprived Labour voters in the cities over better-off but elderly Tories in the shires—but I was struck by the absence of reaction to Andrew Lansley’s claim. He seems to have got clean away with it.

Maybe his many opponents are simply too exhausted by the struggle over the Health and Social Care Bill to open a new front. Maybe they are adopting my default position on all NHS reform, which is that there is less in it than meets the eye. But if this policy is actually implemented it will have substantial effects across the NHS.

Its effect will be to reverse a key pledge entered into …

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