Geographical Resource Allocation in the English National Health Service, 1971-1994: The Tension between Normative and Empirical Approaches

Abstract

The policy response to the problem of developing a geographical resource allocation formula sensitive to relative population needs for hospital and community health services resources in the National Health Service demonstrates a continuing tension between normative and empirical solutions. Since 1988, the balance has shifted in favour of a more empirical approach to identifying and weighting population needs indicators in response to concerns about the theoretically justified, but essentially approximate, nature of the Resource Allocation Working Party formula introduced in 1977–1978. However, judgements and assumptions about the nature of ‘need’ have still to be made in order to construct a usable resource allocation formula since empirical data on what is cannot provide a complete guide to what ought to be a fair distribution of resources in relation to need.