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Dismantling the NHS?Evaluating the Impact of Health Reforms$
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Mark Exworthy, Russell Mannion, and Martin Powell

Print publication date: 2016

Print ISBN-13: 9781447330226

Published to Policy Press Scholarship Online: May 2017

DOI: 10.1332/policypress/9781447330226.001.0001

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Achieving equity in health service commissioning

Achieving equity in health service commissioning

(p.233) Twelve Achieving equity in health service commissioning
Dismantling the NHS?

Martin Wenzl

Elias Mossialos

Policy Press

Equity was one of the main policy goals at the inception of the English National Health Service (NHS). The current literature on equity in healthcare distinguishes between horizontal equity, requiring that equals be treated equally, and vertical equity, requiring that unequals be treated unequally. For a healthcare system to be equitable, both concepts of equity need to be respected in financing and the distribution of services in the population. This requires that contributions be levied based on ability to pay and access to services be based on need. This chapter discusses equity in the NHS prior to 2010. It then summarises the reforms under the Coalition and assess the impact of these reforms. The chapter concludes by stating that equity appears to have been an afterthought in the NHS reforms under the Coalition. The authors recognise that further empirical analyses will be necessary to assess NHS performance on equity once sufficient time has elapsed since the reforms and once processes in the new structure have matured.

Keywords:   NHS, equity, healthcare, access, need, reforms

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