Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T23:07:17.610Z Has data issue: false hasContentIssue false
  • English
  • Français

The National Health Service (NHS) in ‘crisis’: the role played by a shift from horizontal to vertical principles of equity

Published online by Cambridge University Press:  02 August 2018

Sheena Asthana Open the ORCID record for Sheena Asthana [Opens in a new window]  and
Alex Gibson
Sheena Asthana*
Affiliation:
School of Law, Criminology and Government, University of Plymouth, Drake Circus, Plymouth, UK
Alex Gibson
Affiliation:
School of Law, Criminology and Government, University of Plymouth, Drake Circus, Plymouth, UK
*
*Correspondence to: Sheena Asthana, School of Law, Criminology and Government, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK. Email: sasthana@plymouth.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Explanations of the state of ‘crisis’ in the English National Health Service (NHS) generally focus on the overall level of health care funding rather than the way in which funding is distributed. Describing systematic patterns in the way different areas are experiencing crisis, this paper suggests that NHS organisations in older, rural and particularly coastal areas are more likely to be ‘failing’ and that this is due to the historic underfunding of such areas. This partly reflects methodological and technical shortcomings in NHS resource allocation formulae. It is also the outcome of a philosophical shift from horizontal (equal access for equal needs) to vertical (unequal access to equalise health outcomes) principles of equity. Insofar as health inequalities are determined by factors well beyond health care, we argue that this is an ineffective approach to addressing health inequalities. Moreover, it sacrifices equity in access to health care by failing to adequately fund the health care needs of older populations. The prioritisation of vertical over horizontal equity also conflicts with public perspectives on the NHS. Against this background, we ask whether the time has come to reassert the moral and philosophical case for the principle of equal access for equal health care need.

Keywords

NHShorizontal equityvertical equityresource allocationinstitutionalised ageism
Type
Articles
Information
Health Economics, Policy and Law , Volume 15 , Issue 1 , January 2020 , pp. 1 - 17
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anand, P Wailoo, A (2000) Utilities versus rights to publicly provided goods: arguments and evidence from health care rationing. Economica 67(268), 543–577.Google Scholar
Asthana, S Gibson, A (2006) The relationship between the funding formula, the allocation of funds to trusts and the size of their deficits or surpluses. In House of Commons Health Committee (ed.), NHS Deficits: Volume II, Written Evidence, London: The Stationery Office Limited, 152–159.Google Scholar
Asthana, S Gibson, A (2008a) Deprivation, demography and the distribution of general practice: challenging the conventional wisdom of inverse care. British Journal of General Practice 58(555), 718–727.Google Scholar
Asthana, S Gibson, A (2008b) Health care equity, health equity and resource allocation: towards a normative approach to achieving the core principles of the NHS. Radical Statistics 96: 6–26.Google Scholar
Asthana, S Gibson, A (2011) Setting health care capitations through diagnosis-based risk adjustment: a suitable model for the English NHS? Health Policy 101(2), 133–139.Google Scholar
Asthana, S Gibson, A (2013) Francis and funding: an explanation for ‘failing’ hospitals. Health Service Journal.Google Scholar
Asthana, S, Gibson, A Halliday, J (2012) The medicalisation of health inequalities and the English NHS: the role of resource allocation. Health Economics, Policy and Law 8(2), 167–183.Google Scholar
Asthana, S, Gibson, A, Moon, G, Dicker, J Brigham, P (2004a) The demographic and social class basis of inequalities in morbidity: a comparison. Journal of Epidemiology and Community Health 58(4), 303–307.Google Scholar
Asthana, S, Gibson, A, Moon, G, Dicker, J Brigham, P (2004b) The pursuit of equity in NHS resource allocation: should morbidity replace utilisation as the basis for setting health care capitations? Social Science & Medicine 58(3): 539–551.Google Scholar
Asthana, S Halliday, J (2006) What Works in Tackling Health Inequalities? Pathways, Policies and Practice through the Lifecourse, Bristol: Policy Press.Google Scholar
Barr, B, Kinderman, P Whitehead, M (2015) Trends in mental health inequalities in England during a period of recession, austerity and welfare reform 2004 to 2013. Social Science & Medicine 147: 324–331.Google Scholar
Bartley, M (2016) Health Inequality: An Introduction to Concepts, Theories and Methods, 2nd edn, Cambridge: Polity Press.Google Scholar
Bevan, G (2009) The search for a proportionate car law by formula funding in the English NHS. Financial Accountability & Management 25(4), 391–410.Google Scholar
Birch, S Donaldson, C (2003) Valuing the benefits and costs of health care programmes: where’s the ‘extra’ in extra-welfarism? Social Science & Medicine 56(5), 1121–1133.Google Scholar
Bowling, A (1996) Health care rationing: the public’s debate. British Medical Journal 312(7032), 670–674.Google Scholar
Brazier, J, Ratcliffe, J, Tsuchiya, A Salomon, J (2007) Measuring and Valuing Health Benefits for Economic Evaluation, Oxford: Oxford University Press.Google Scholar
Brouwer, WBF, Culyer, AJ, van Exel, NJA Rutten, FFH (2008) Welfarism vs. extra-welfarism. Journal of Health Economics 27: 325–338.Google Scholar
Busschbach, JJV, Hessing, DJ de Charro, FT (1993) The utility of health at different stages in life: a quantitative approach. Social Science & Medicine 37(2), 153–158.Google Scholar
Carr-Hill, R, Hardman, G, Martin, S, Peacock, S, Sheldon, T Smith, P (1994) A Formula for Distributing NHS Revenues Based on Small Area Use of Hospital Beds, York: University of York; Centre of Health Economics.Google Scholar
Carr-Hill, R, Hardman, G, Martin, S, Peacock, S, Sheldon, T Smith, P (1997) A new formula for distributing hospital funds in England. Interfaces 27: 53–70.Google Scholar
Charlson, ME, Charlson, RE, Peterson, JC, Marinopoulos, SS, Briggs, WM Hollenberg, JP (2008) The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. Journal of Clinical Epidemiology 61(12), 1234–1240.Google Scholar
Charny, MC, Lewis, PA Farrow, SC (1989) Choosing who shall not be treated in the NHS. Social Science & Medicine 28(12), 1331–1338.Google Scholar
Coast, J (2009) Maximisation in extra-welfarism: a critique of the current position in health economics. Social Science & Medicine 69(5), 786–792.Google Scholar
Coast, J, Smith, RD Lorgelly, P (2008) Welfarism, extra-welfarism and capability: the spread of ideas in health economics. Social Science & Medicine 67: 1190–1198.Google Scholar
Coast, J, Donovan, J, Litvab, A, Eyles, J, Morgan, M, Shepherd, M Tacchie, J (2002) ‘If there were a war tomorrow, we’d find the money’: contrasting perspectives on the rationing of health care. Social Science & Medicine 54: 1839–1851.Google Scholar
Coleman MP, Forman D, Bryant H, Butler J, Rachet B, Maringe C, Nur U, Tracey E, Coory M, Hatcher J, McGahan CE, Turner D, Marrett L, Gjerstorff ML, Johannesen TB, Adolfsson J, Lambe M, Lawrence G, Meechan D, Morris EJ, Middleton R, Steward J, Richards MA and ICBP Module 1 Working Group (2011) Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 377(9760), 127–138.Google Scholar
Cookson, R (2005) QALYs and the capability approach. Health Economics 14: 817–829.Google Scholar
Cookson, R Dolan, P (1999) Public views on health care rationing: a group discussion study. Health Policy 9(1–2), 63–74.Google Scholar
Cookson, R Laudicella, M (2011) Do the poor cost much more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001 to 2008. Social Science & Medicine 72: 173–184.Google Scholar
Corfe, S (2017) Living on the Edge: Britain’s Coastal Communities, London: Social Market Foundation.Google Scholar
Cramme, O, Diamond, P McTernan, M (2013) Introduction: governing from the left. In O Cramme, P Diamond and M McTernan (eds) Progressive Politics After the Crash: Governing from the Left, London: IB Tauris Publications, 1–18.Google Scholar
Culyer, AJ (1989) The normative economics of health care finance and provision. Oxford Review of Economic Policy 5(1), 34–56.Google Scholar
Culyer, AJ (2001) Equity – some theory and its policy implications. Journal of Medical Ethics 27: 275–283.Google Scholar
Culyer, AJ (2006) The Bogus conflict between efficiency and equity. Health Economics 15: 1155–1158.Google Scholar
Culyer, AJ (2012) Need: the idea won’t do but we still need it. In R Cookson and K Claxton (eds) The Humble Economist: Tony Culyer on Health, Health Care and Social Decision Making York: York Publishing Services Ltd..Google Scholar
Culyer, AJ Wagstaff, A (1993) Equity and equality in health and health care. Journal of Health Economics 12: 431–457.Google Scholar
Cunic, D, Lacombe, S, Mohajer, K, Grant, H Wood, G (2014) Can the Blaylock Risk Assessment Screening Score (BRASS) predict length of hospital stay and need for comprehensive discharge planning for patients following hip and knee replacement surgery? Predicting arthroplasty planning and stay using the BRASS. Canadian Journal of Surgery 57(6), 391–397.Google Scholar
de Bruijne, MC, van Rosse, F, Uiters, E, Droomers, M, Suurmond, J, Stronks, K Essink-Bot, ML (2013) Ethnic variations in unplanned readmissions and excess length of hospital stay: a nationwide record-linked cohort study. European Journal of Public Health 23(6), 964–971.Google Scholar
Department of Health (DH) (2012) The NHS Constitution. https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england [19 March 2018].Google Scholar
Dixon, J, Smith, P, Gravelle, H, Martin, S, Bardsley, M, Rice, N, Georgiou, T, Dusheiko, M, Billings, J, De Lorenzo, M Sanderson, C (2011) A person based formula for allocating commissioning funds to general practices in England: development of a statistical model. British Medical Journal 343: d6608. www.bmj.com/content/343/bmj.d6608.Google Scholar
Dolan, P, Shaw, R, Tsuchiya, A Williams, A (2005) QALY maximisation and people’s preferences: a methodological review of the literature. Health Economics 14: 197–208.Google Scholar
Dworkin, R (1993) Life’s Dominion: An Argument About Abortion and Euthanasia, London: Harper Collins.Google Scholar
Evans, R (1984) Strained Mercy: The Economics of Canadian Health Care, Toronto: Butterworths. p. 5; cited by Birch S and Donaldson C (2003).Google Scholar
Faiz, O, Haji, A, Burns, E, Bottle, A, Kennedy, R Aylin, P (2011) Hospital stay amongst patients undergoing major elective colorectal surgery: predicting prolonged stay and readmissions in NHS hospitals. Colorectal Disease 13(7): 816–822.Google Scholar
Gainsbury, S (2017) The Bottom Line. Understanding the NHS Deficit and Why It Won’t Go Away, London: Nuffield Trust. https://www.nuffieldtrust.org.uk/files/2017-08/the-bottom-line-final-v2a.pdf.Google Scholar
Galea, A, Dixon, A, Knox, A Wellings, D (2013) How Should We Pay for Health Care in Future? Results of Deliberative Events with the Public, London: The King’s Fund.Google Scholar
Gershlick, B, Charlesworth, A Taylor, E (2015) Public Attitudes to the NHS. An Analysis of Responses to Questions in the British Social Attitudes Survey, London: The Health Foundation. http://www.health.org.uk/sites/health/files/PublicAttitudesToTheNHS.pdf.Google Scholar
Graham, H (2004) Social determinants and their unequal distribution: clarifying policy understandings. The Milbank Quarterly 82: 101–124.Google Scholar
Hansard (2009) Written Questions, 12 January: Column 177W. London: The Stationery Office. Google Scholar
Harris, J (1989) The Value of Life, London: Routledge.Google Scholar
Harris, J (2005) It’s not NICE to discriminate. Journal of Medical Ethics 31: 373–375.Google Scholar
Health Foundation (2017) Healthy Lives for People in the UK: Introducing the Health Foundation’s Healthy Lives Strategy London: the Health Foundation. http://www.health.org.uk/sites/health/files/HealthyLivesForPeopleInTheUK.pdf.Google Scholar
Hollowell, J, Grocott, MP, Hardy, R, Haddad, FS, Mythen, MG Raine, R (2010) Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stay. Journal of Evaluation in Clinical Practice 16(3), 529–538.Google Scholar
Jowell, R, Curtice, J, Park, A, Brook, L Thomson, K (1998) British and European Social Attitudes: The 15th Report Aldershot: Ashgate.Google Scholar
Kessel, A Haines, A (2010) What the White Paper might mean for public health. British Medical Journal 341: c6623.Google Scholar
Lafond, S, Charlesworth, A Roberts, A (2016) A Perfect Storm: An Impossible Climate for NHS Providers’ Finances? An Analysis of NHS Finances and Factors Associated with Financial Performance, London: The Health Foundation.Google Scholar
Lockwood, M (1988) Quality of life and resource allocation. In JM Bell and S Mendus (eds) Philosophy and Medical Welfare, Cambridge: Cambridge University Press.Google Scholar
Loopstra, R, Mckee, M, Katikireddi, SV, Taylor-Robinson, D, Barr, B Stuckler, D (2016) Austerity and old-age mortality in England: a longitudinal cross-local area analysis, 2007–2013. Journal of the Royal Society of Medicine 109: 109–116.Google Scholar
Mackenbach, JP (2015) The persistence of health inequalities in modern welfare states: the explanation of a paradox. Social Science & Medicine 75(4), 761–769.Google Scholar
Maringe, C, Walters, S, Rachet, B, Butler, J, Fields, T, Finan, PJ, Maxwell, R, Nedrebø, B, Påhlman, L, Sjövall, A, Spigelman, A, Engholm, G, Gavin, A, Gjerstorff, ML, Hatcher, J, Borge Johannesen, T, Morris, EJ, McGahan, CE, Tracey, E, Turner, D, Richards, MA Coleman, MP, ICBP Module 1 Working Group (2013) Stage at diagnosis and colorectal cancer survival in six high-income countries: a population-based study of patients diagnosed during 2000-7. Acta Oncologica 52: 919–932.Google Scholar
Marmot, M (2015) Status Syndrome: How Your Place on the Social Gradient Directly Affects Your Health, London: Bloomsbury.Google Scholar
Marmot, M, Allen, J, Goldblatt, P Boyce, T (2010) Strategic review of health inequalities in England post-2010. Marmot review final report. University College London, London.Google Scholar
Maynard, A (1996) Rationing health care. What use citizen’s juries and priority committees if principles of rationing remain implicit and confused? British Medical Journal 313: 1499.Google Scholar
Mays, N (1995) Geographical resource allocation in the English National Health Service, 1974-1994: the tension between normative and empirical approaches. International Journal of Epidemiology 24: S96–102.Google Scholar
McGovern, L, Miller, G Hughes-Cromwick, P (2014) Health policy brief: The relative contribution of multiple determinants to health outcomes. Health Affairs. doi: 10.1377/hpb20140821.404487.Google Scholar
Moller, H, Flatt, G Moran, A (2011) High cancer mortality rates in the elderly in the UK. Cancer Epidemiology 35(5), 407–412.Google Scholar
Mooney, G (1983) Equity in health care: confronting the confusion. Effective Health Care 1(4), 179–185.Google Scholar
Mooney, G Jan, S (1997) Vertical equity: weighting health outcomes? or establishing procedures? Health Policy 39: 79–88.Google Scholar
Morris, S, Carr-Hill, R, Dixon, P, Rice, N, Sutton, M Vallejo-Torres, L (2007) Combining Age Related and Additional Needs (CARAN) Report 2007 Review of the Needs Formulae for Hospital Services and Prescribing Activity in England. Resource Allocation Research Papers 30. London: Department of Health.Google Scholar
National Cancer Equality Initiative/Pharmaceutical Oncology Initiative (2012) The Impact of Patient Age on Clinical Decision Making in Oncology. Department of Health. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215155/dh_133095.pdf [19 March 2018].Google Scholar
National Institute for Clinical Excellence (NICE) (2006) Citizens Council’s Report on Inequalities in Health. London: National Institute for Clinical Excellence. https://www.nice.org.uk/Media/Default/Get-involved/Citizens-Council/Reports/CCReport07HealthInequalities.pdf.Google Scholar
Neuberger, J, Adams, D, MacMaster, P, Maidment, A Speed, M (1998) Assessing priorities for allocations of donor liver grafts: survey of public and clinicians. British Medical Journal 317: 172–175.Google Scholar
NHS Digital ( undated), Quality and Outcome Framework data for 2013/14. https://digital.nhs.uk/catalogue/PUB15751 [19 March 2018].Google Scholar
NHS England Analytical Services (Finance) (2016). Refreshing the Formulae for CCG Allocations for allocations to Clinical Commissioning Groups from 2016-17 - Report on the methods and modelling. Leeds: NHS Analytical Services. https://www.england.nhs.uk/publication/refreshing-the-formulae-for-ccg-allocations-for-allocations-to-clinical-commissioning-groups-from-2016-17-report-on-the-methods-and-modelling-nhs-england-analytical-services-finance/ [20 March 2018].Google Scholar
NHS England (2016) CCG Assurance Annual Assessment 2015/16. https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/07/annual-assessment-rep-2015-16-upd.pdf [19 March 2018].Google Scholar
NHS England (2017a), CCG Improvement and Assessment Framework 2017/18. https://www.england.nhs.uk/wp-content/uploads/2017/11/ccg-improvement-and-assessment-framework-2017-18.pdf [19 March 2018].Google Scholar
NHS England (2017b), Next Steps forward on the Five Year Forward View. https://www.england.nhs.uk/wp-content/uploads/2017/03/NEXT-STEPS-ON-THE-NHS-FIVE-YEAR-FORWARD-VIEW.pdf [19 March 2018].Google Scholar
NHS England (undated, a), Financial Performance Report: Fourth Quarter 2015/16. https://www.england.nhs.uk/wp-content/uploads/2016/06/financial-info-fourth-quarter-1516.pdf [19 March 2018].Google Scholar
NHS England (undated, b), Financial Performance Report: Fourth Quarter 2016/17. https://www.england.nhs.uk/wp-content/uploads/2017/09/financial-report-q4-16-17.pdf [19 March 2018].Google Scholar
NHS England (undated, c), Programme Budget Category data. https://www.england.nhs.uk/resources/resources-for-ccgs/prog-budgeting/ [19 March 2018].Google Scholar
NHS England (undated, d), 2016 Commissioning for Value (CfV) CCG data packs. https://www.england.nhs.uk/rightcare/products/ccg-data-packs/ [19 March 2018].Google Scholar
NHS England (undated, e), 2016/17 Quarterly Commissioner Based Cancer Waiting Times Statistics. https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/quarterly-comm-cwt/201617-quarterly-commissioner-based-cancer-waiting-times-statistics/ [19 March 2018].Google Scholar
NHS England (undated, f), Consultant-led Referral to Treatment Waiting Times Data 2016-17. https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2016-17/ [19 March 2018].Google Scholar
NHS England (undated, g), Quarterly Diagnostic Waiting Times. https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/diagnostics-census-data/ [19 March 2018].Google Scholar
NHS England (undated, h)https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2017/07/ccgiaf-tech-annex-1617.pdf. via https://www.england.nhs.uk/commissioning/ccg-assess/ [19 March 2018].Google Scholar
NHS England (undated, i), 2016/17 Monthly Commissioner Cancer Waiting Times Statistics. https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/monthly-comm-cwt/201617-monthly-comm-cwt/ [19 March 2018].Google Scholar
NHS England, Public Health England, Health Education England, Monitor, Care Quality Commission, NHS Trust Development Authority (2014) Five Year Forward View . https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf [23 March 2018].Google Scholar
NHS Improvement (2017) Performance of the NHS provider sector for the month ended 30 September 2017. https://improvement.nhs.uk/uploads/documents/Performance_of_the_NHS_Provider_sector_month_ended_30_Sept_Final_17_Nov.pdf [19 March 2018].Google Scholar
Nord, E, Street, A, Richardson, J, Kuhse, H Singer, P (1996) The significance of age and duration of effect in social evaluation of health care. Health Care Analysis 4: 103–111.Google Scholar
Norheim, OF (2009) A note on Brock: prioritarianism, egalitarianism and the distribution of life years. Journal of Medical Ethics 35(9), 565–569.Google Scholar
Office for National Statistics (ONS) (2011) http://geoportal.statistics.gov.uk/datasets/rural-urban-classification-2011-of-ccgs-including-population-in-england [19 March 2018].Google Scholar
Office for National Statistics (ONS) (undated, a), Mid-year estimates for 2014 (Mid-2014: SAPE17DT5). https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/clinicalcommissioninggroupmidyearpopulationestimates [19 March 2018].Google Scholar
Office for National Statistics (ONS) (undated, b), Mid-year estimates for 2016 (Mid-2016: SAPE19DT5). https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/clinicalcommissioninggroupmidyearpopulationestimates [19 March 2018].Google Scholar
Parfit, D (1997) Equality and priority. Ratio 10(3), 202–221.Google Scholar
Pritchard KI (2007) Have we been guilty of ageism in the primary treatment of breast cancer? Br J Cancer 96: 1011-1012. Google Scholar
Pearce, J (2013) Commentary: financial crisis, austerity policies, and geographical inequalities in health. Environment and Planning A 45: 2030–2045.Google Scholar
Ring A (2010) The influences of age and co-morbidities on treatment decisions for patients with HER2-positive early breast cancer. Crit Rev Oncol Hematol 76: 127-132. Google Scholar
Scambler, G (2001) Critical realism, sociology and health inequalities: social class as a generative mechanism and its media of enactment. Journal of Critical Realism 4: 35–42.Google Scholar
Sen, A (1993) Capability and well-being. In MC Nussbaum and AK Sen (eds) The Quality of Life, Oxford: Clarendon Press.Google Scholar
Sen, A (1999) Development as Freedom, Oxford: Oxford University Press.Google Scholar
Sen, A (2002) Why health equity? Health Economics 11: 659–666.Google Scholar
Sheldon, T Carr-Hill, R (1993) Weighting in the dark: resource allocation in the new NHS. British Medical Journal 306: 835–839.Google Scholar
Sheldon, TA Carr-Hill, RA (1992) Resource allocation by regression in the NHS: a statistical critique of the RAWP review. Journal of the Royal Statistical Society A 155: 403–420.Google Scholar
Smith PC (2006) Formula Funding of Public Services, Abingdon, Oxon: Routledge. Google Scholar
Smith, KE Eltanani, MK (2015) What kinds of policies to reduce health inequalities in the UK do researchers support? Journal of Public Health 37(1), 6–17.Google Scholar
Stone, M (2006) Eye of Newt and Toe of Frog: A Good Formula for Health? Civitas Report. http://www.civitas.org.uk/pdf/StonePCTFunding.pdf [19 March 2018].Google Scholar
Stone M (2007) Supplementary evidence (Def07A). In House of Commons Health Committee, NHS Deficits: First Report of Session 2006-07 Volume II. London: The Stationery Office Limited. Google Scholar
Stone, M Galbraith, J (2006) How not to fund hospital and community health services in England. Journal of the Royal Statistical Society (Series A) 169(1), 143–164.Google Scholar
Sutton, M, Gravelle, H, Morris, S, Leyland, A, Windmeijer, F, Dibben, C Muirhead, M (2002) Allocation of Resources to English Areas; Individual and small area determinants of morbidity and use of healthcare resources. Report to the Department of Health. Edinburgh: Information and Statistics Division.Google Scholar
Sutton, M, Kristensen, SR, Lau, Y, Glover, G, Whittaker, W, Wildman, J, Gravelle, H Smith, P (2012) Estimation of a formula for mental health services based on person-level data. Report to the Advisory Committee on Resource Allocation. http://www.england.nhs.uk/wp-content/uploads/2013/08/ann-c1-res-all-mh.pdf.Google Scholar
Tsuchiya, A (1999) Age-related preferences and age weighting health benefits. Social Science & Medicine 48(2), 267–276.Google Scholar
Tsuchiya, A (2000) QALYs and ageism: philosophical theories and age weighting. Health Economics 9: 57–68.Google Scholar
Tsuchiya, A Williams, A (2005) A ‘fair innings’ between the sexes: are men being treated inequitably? Social Science & Medicine 60: 277–286.Google Scholar
Walters S, Maringe C, Coleman MP, Peake MD, Butler J, Young N, Bergström S, Hanna L, Jakobsen E, Kölbeck K, Sundstrøm S, Engholm G, Gavin A, Gjerstorff ML, Hatcher J, Johannesen TB, Linklater KM, McGahan CE, Steward J, Tracey E, Turner D, Richards MA, Rachet B and ICBP Module 1 Working Group (2013) Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the United Kingdom: a population-based study, 2004–2007. Thorax 68: 551–564.Google Scholar
Williams, A (1997) Intergenerational equity: an exploration of the ‘fair innings’ argument. Health Economics 6: 117–132.Google Scholar