Allocating Health Care Resources in the UK: Putting Principles into Practice

© Oxford University Press 2012. All rights reserved. This chapter examines the ethical principles behind just allocation of health care resources in the UK, with particular emphasis on the National Health Service (NHS). These ethical considerations include equality of outcome and equality of persons or equity; the latter can be considered through the principles of fair process, need, and rescue. The chapter analyzes how these ethical principles work in practice on the national, regional, and local levels. The national level is governed by the National Institute for Health and Clinical Excellence, and uses the principles of cost effectiveness and equity in order to make fiscal and clinical recommendations to the lower levels. The chapter also looks at the Oxfordshire Primary Care Trust and how it uses the South Central Ethical Framework to make decisions about why an individual patient should receive a treatment that is not usually covered by the NHS. Finally, it discusses the issue of rescue and Individual Funding Request (IFR) panels.