Intended for healthcare professionals

Letters Allocation of NHS resources

Clear winners and losers are created by age only NHS resource allocation

BMJ 2012; 344 doi: (Published 22 May 2012) Cite this as: BMJ 2012;344:e3593
  1. Clare L Bambra, professor of public health policy1
  1. 1Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton on Tees TS17 6BH, UK
  1. clare.bambra{at}

Hawkes points out the dangerous implications for health inequalities of an age only proposal for NHS resource allocation: there would certainly be winners and losers.1 Severing the link with deprivation will lead to a considerable shift of healthcare funding away from the neediest, poorer areas of the north and the inner cities towards the least needy, most affluent, and most elderly areas of the south. It also means more money for areas voting Conservative and less for those voting Labour.

I examined the impact of age only allocation by recalculating the 2011-2 NHS resource allocation by English strategic health authorities.2 The table shows the changes when the coefficient weightings for health need, deprivation related need, and disability-free life expectancy are removed. If an age only allocation approach had been taken in 2011-2 there would have been a 14.9% and 12.0% loss of resource in the poorer north east and north west regions (£265 and £209 per head). The regional winners would have been the more affluent south east coast and south central areas, with increases of 12.6% and 15.8% (£188 and £220 per head). Regions that would have the biggest gains have a higher proportion of electors who voted Conservative; the biggest potential losses are concentrated in areas with more support for Labour.

NHS age only resource allocation targets by English strategic health authority for 2011-2 with voting pattern

View this table:

These data suggest that age only NHS resource allocation, which ignores the important link between deprivation and health, would disproportionately benefit areas of England that are the most healthy, most affluent, and most likely to vote Conservative: “Medicine is a social science, and politics nothing but medicine at a larger scale.”4


Cite this as: BMJ 2012;344:e3593


  • I thank Alison Copeland and Adetayo Kasim for advice on the data analysis.

  • Competing interests: CLB is a member of the Labour party.

  • For the full rapid response and tables see


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