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The search for a proportionate care law by formula funding in the English NHS

By Gwyn Bevan


Although the National Health Service was created to achieve equity of access to health care in 1948, over twenty years later an ‘inverse care law’ was seen to operate. The 1976 Report of the Resource Allocation Working Party laid the principles of formula funding to achieve an equitable distribution of resources, to move, over time, towards the operation of a proportionate care law. These principles have been applied ever since in England. This paper describes the context, governance and subsequent development of formulas and three persistent problems: accounting for populations, their needs and variations in the unavoidable costs of providers. The paper concludes by outlining continuing problems from the past and new challenges of formula funding in England to reduce ‘avoidable’ inequalities in health

Topics: HD28 Management. Industrial Management, HN Social history and conditions. Social problems. Social reform
Publisher: Blackwell Publishing
Year: 2009
DOI identifier: 10.1111/j.1468-0408.2009.00484.x
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Provided by: LSE Research Online
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