Health Policy

Abstract

A significant feature of the operation of the National Health Service (NHS) throughout its history has been the relationship between the perceived need to contain the costs of the service within what the politicians have seen as ‘reasonable bounds’ and the goals of efficiency and equity that form the crucial part of the explicit rationale for introducing the service. Efficiency was taken to imply ‘rational planning’ and ‘effective management’ of health care resources. Equity implied the perhaps utopian goals of equal access according to need and irrespective of ability to pay.