Dobson Must Quit Denial Of Rationing

October 09, 1998

Puzzling out priorities. We must acknowledge that rationing is a political process

In his editorial in this week's BMJ Professor Rudolf Klein from the King's Fund calls on the British government to acknowledge that setting priorities in health care is inescapably a political process. He argues that Frank Dobson, the Secretary of State for Health, will only make himself "look foolish and undermine his credibility" if he continues to ban the word from ministerial vocabulary. Professor Klein writes that once the inevitability of rationing is finally accepted "we can get down to the serious business of discussing how to devise the appropriate mechanisms... involved".

The author proposes that a National Council for Health Care Priorities would provide a forum and a focus for the rationing debate in the UK. However, he ponders the role of such a body and concludes that this reflects the general dilemma about how to develop the way we think about rationing, which in turn reinforces the case for more debate. He believes that rationing decisions, no matter who they are made by, should have to pass the test of being reasonable (whereby most people would regard them as being relevant and fair, without necessarily agreeing with the decision).


Professor Rudolf Klein, Senior Associate, King's Fund, London


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