ABSTRACT
Culyer and Wagstaff [38] provided the most in¡uential denition of need for healthcare, namely that a need is equal to a person’s capacity to benet from healthcare (i.e. there is only a need for healthcare when an effective treatment exists). An individual’s capacity to benet for a particular healthcare intervention may vary according to factors such as gender, age, or illness severity as well as their adherence
The concepts of need and social justice are much debated since they lie at the heart of health policy in many countries. For example, one of the principles of the NHS is a commitment to distributive justice through the principle of equal access for equal need. Likewise, a commitment to procedural justice underpins the right to fair process in decision-making about rationing and prioritisation in healthcare. This chapter begins with a description of various concepts relating to the concepts of need and social justice, and how they relate to other healthcare priorities such as efciency. The remainder of the chapter discusses how healthcare policy is made, including the extent to which policymaking is based on the principles of social justice and equity for different population groups.
