Abstract
In any discussion of the distribution of opportunities which is concerned, as we are concerned, with the extent of inequalities in standards of living, the state of a nation’s health is a matter of crucial importance. For individuals the experience of sickness may range from total incapacity to minor disability or discomfort, but whatever its character it is likely to interfere to a greater or lesser degree with work and social activities and personal well-being. For the country as a whole sickness is an economic cost through loss of production and claims on medical services. In this chapter we shall examine the population’s health, trying to distinguish those factors which are significant in determining the demand or need for medical care, and the supply of medical services — especially government provision. We shall then look at the relation between supply, demand and need to see how far the distribution of medical care accords with citizenship or socialist values.
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Notes
See Ethel Shanas et al., Old People in Three Industrial Societies (Routledge & Kegan Paul, 1968) with reference to the dangers of relying on people’s own assessments of their medical condition.
See, for example, C. T. Dollery, ‘The Quality of Health Care’, in Challenges for Change, ed. Gordon McLachlan (Oxford University Press, 1971); Brian Abel-Smith, ‘Public Expenditure on the Social Services’, Social Trends, no. 1 (1970);
A. J. Culyer, R. J. Lavers and Alan Williams, ‘Health Indicators’, in Social Indicators and Social Policy, ed. Andrew Shonfield and Stella Shaw (Heinemann, 1972).
B. E. Coates and E. M. Rawstrom, Regional Variations in Britain (Batsford, 1971) pp. 227 ff.
C. A. Moser and Wolf Scott, British Towns (Oliver & Boyd, 1961) appendix B.
Office of Population Censuses and Surveys, The General Household Survey, Introductory Report (H.M.S.O., 1973) table 8.10.
D.H.S.S., Hospital Costing Returns for 1973 (H.M.S.O., 1973). The cost of a hospital bed is, of course, a very inadequate guide to the quality of medical care, but nevertheless the variations are suggestive.
D.H.S.S., Annual Report 1972, Cmnd. 5352 (H.M.S.O., 1973) p. 180.
Rosemary Stevens, Medical Practice in Modern England (Yale, 1966) part iv.
Ministry of Health, Health and Welfare, Cmnd. 3022 (H.M.S.O., 1966).
Michael Lee, Opting out of the N.H.S. (P.E.P., 1971) p. 12.
Samuel Mencher, Private Practice in Britain (Bell, 1967) pp. 16.
R. M. Titmuss, Essays on the Welfare State, 2nd ed. (Allen & Unwin, 1963) ‘Appendix to Lectures on the National Health Service in England’.
D.H.S.S., Annual Report 1970, Cmnd. 4714 (H.M.S.O., 1971) table 59 and p. 226.
Rosemary Stevens, Medical Practice in Modern England (Yale University Press, 1966); Abel-Smith, ‘Public Expenditure on the Social Services’; Halsey (ed.), Trends in British Society, chap. 11.
See Thomas McKeown, Medicine in Modern Society (Allen & Unwin, 1965); Report of the Royal Commission of Medical Education, 1965–68, Cmnd. 3569 (H.M.S.O., 1968).
See the report on current research from the D.H.S.S. in Gordon McLachlan (ed.), Portfolio for Health (Oxford University Press, 1971).
G. K. Matthews, ‘Measuring Need and Evaluating Services’, in ibid. Also Andrew Shonfield and Stella Shaw (eds), Social Indicators and Social Policy (Heinemann, 1972) chap. 6, for a discussion of the problems involved in trying to measure medical need and changes in standards of health.
Brian Abel-Smith, ‘Ombudsman’ in New Society (2 March 1972).
D.H.S.S., National Health Service Reorganisation, Consultative Document (May 1971).
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© 1975 Julia Parker
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Parker, J. (1975). The Distribution of Health. In: Social Policy and Citizenship. Palgrave, London. https://doi.org/10.1007/978-1-349-15583-5_5
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DOI: https://doi.org/10.1007/978-1-349-15583-5_5
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