It is a commonplace observation that the real costs of healthcare are rising inexorably, year on year, in every developed nation worldwide. It is absolutely clear that no nation can afford all the possible treatments which might be provided for its citizens.
At the same time, the shameful gulf in resources between the developed and less-developed worlds increases. Rationing of scarce health resources is inevitable in every society in the world. But how should resources be allocated in a way which fits with Christian convictions?
In the UK, the traditional solution within the NHS has been that of covert rationing by doctors and managers. In ways which are frequently concealed from the patient and the general public, doctors and managers have restricted the availability of treatment to those whom they believe can most benefit, or to those who seem most worthy of treatment. Traditionally, priority has often been given to those with the greatest medical need who were most likely to benefit from treatment. This has meant that those with serious acute illness and those with most dependants have often been given preference over people with learning disabilities, mental illness, the diseases of old age, or chronic disability. In response to public pressure and a desire by managers to reform the process of allocation, managers and health planners have started to experiment with alternative models which make allocation decisions more open and transparent.
