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Cover Mason and McCall Smith's Law and Medical Ethics

5. Health Resource Allocation  

A. M. Farrell and E. S. Dove

This chapter discusses the allocation of health resources. No resources are finite, and this certainly applies in the health context. Across the UK’s four nations, health care is free at the point of need; this raises complex political and ethical questions about adequate funding, an appropriate calibration of supply and demand, and balance between maximising health and promoting health equity. This chapter explores allocation at the global, national, and individual levels, looking in depth at metrics such as the quality-adjusted life year (QALY) and organisations such as the National Institute for Health and Care Excellence (NICE), a public body that produces evidence-based guidance and advice for care practitioners, develops quality standards and performance metrics for those providing and commissioning care services, and provides a range of information services for commissioners, practitioners, and managers across health and social care. This chapter emphasises that while NICE and similar bodies aim to make decisions grounded in clinical need and efficiency, inevitably they must also include a consideration of what is best for the health service itself, and this means that scientific value and social value judgements cannot be dissociated in such a taxation-funded service.