ABSTRACT
The National Health Service (NHS) was established to provide equitable healthcare provision according to need, irrespective of wealth or geographical location. To define certain care needs as social rather than health related transfers the funding of such services from the NHS to social services. The allocation of funds according to need has been a traditional function of the NHS. Utilitarian philosophy suggests that funds should be used to provide maximum benefit. It is argued that the use of effectiveness data alone perpetuates the inefficient use of resources and that rationing in healthcare must be informed by knowledge of the costs and consequences of alternative interventions. In the past, healthcare has been extensively rationed by age. There is evidence that older people have been discriminated against with regard to renal replacement therapy, cardiological interventions and cancer treatments.
