<p>It is widely accepted proposition that one of the aims of the UK National Health Service is to allocate health care on the basis of need. However, while there may be considerable consensus over the legitimacy of this goal, there is also considerable debate as to whether the goal has been met. If care is allocated according to need, then the corollary is, after controlling for difference in need, there should be no systematic differences in the amount of care received by persons of different ability to pay. Allocation according to need means that ability to pay should be unimportant. Thus an empirical test of whether the NHS allocates according to need is to examine horizontal equity in the delivery of health care, controlling for differences in need.</p>
Authors
Richard Upward
Carol Propper
Research Fellow Imperial College London
Carol is a Research Fellow at the IFS and a Professor of Economics in the Department of Management and Imperial College Business School, London.
Journal article details
- ISSN
- Print: 0143-5671 Online: 1475-5890
- Issue
- February 1992
Suggested citation
Propper, C and Upward, R. (1992). 'Need, equity and the NHS: the distribution of health care expenditure 1974-87' (1992)
More from IFS
Understand this issue
Spring Budget 2024: What you need to know
podcast
IFS reaction to the Chancellor's Spring Budget.
7 March 2024
IFS Deputy Director Carl Emmerson made a Fellow of the Academy of Social Sciences
announcement
Deputy Director Carl Emmerson has been elected as a Fellow of the Academy of Social Sciences.
4 March 2024
The way Chancellors respond to economic news adds to our debt - here's why
explainer
Chancellors don’t respond symmetrically to good and bad economic news. The result is higher debt.
1 March 2024
Policy analysis
What you need to know about the new childcare entitlements
comment
This comment looks at who will be eligible for free childcare, whether funding is high enough and what impact the new entitlements might have.
28 March 2024
Oil and gas make Scotland’s underlying public finances particularly volatile and uncertain
comment
A fallback in oil and gas prices has hit Scotland’s underlying public finance position this year.
27 March 2024
Gap between higher- and lower-paid public sector workers falls by more than a third since 2007 as doctors and experienced teachers have faced unprecedented pay cuts
press release
How has public sector pay changed in recent years? Which type of workers have done better and which have done worse?
26 March 2024
Academic research
Willingness to pay for improved public education and public healthcare systems: the role of income mobility prospects
journal article
These findings are based on more than 19,000 observations from the third round of the Life in Transition Survey.
14 March 2024
Unfunded mandates and taxation
journal article
In mid-2006, the Chinese central government increased the salaries and pensions of civil servants in its coastal areas but a funded mandate in others.
14 March 2024
Does the value-added tax add value? Lessons using administrative data from a diverse set of countries
journal article
We draw on firm-level administrative VAT records from 11 countries at different income levels to examine the functioning of real-world VAT systems.
9 February 2024