ABSTRACT
National Health Service (NHS) funding has been a source of debate since 1948. William Beveridge, whose epochal report established the NHS, seems to have believed that, once the backlog of health needs were met, funding requirements for the new health service would actually decline. The ageing population, the growth in costly new treatments and technologies and an increasingly well-informed public mean that the need to prioritise will intensify. The gap between what is demanded and what can be supplied from the public purse leads to the inevitability of rationing. Health economists define need as the capacity to benefit so the use of needs assessment is crucial to determining which interventions for which health and healthcare issues are likely to benefit the population most and so become priorities. Populations vary according to age, sex, ethnicity and many other determinants of health. Governments come to power with their own electoral commitments; these will be shaped within the Department of Health.
