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Abstract Four potential pressures are likely to determine whether the NHS will be able to cope in future: the change in population structure, changes in level of morbidity, introduction of [...]

In a series of papers published during the past decade Richard Wilkinson has advanced the view that income inequality is the key determinant of variations in average life expectancy at […]

The concepts of class, race, and ethnicity figure prominently in health services research in Britain. Occupational class has been employed for nearly a century to investigate social inequalities in health and access to care. More recently, researchers have identified differences in health status and utilization between ethnic groups. This article examines how these constructs are defined in Britain and identifies some key research associated with them. It also draws attention to the considerable problems in using class and ethnicity to stratify the population. The authors conclude that a new approach that directly measures individuals' material and social resources needs to be developed. Key Words. Race, ethnicity, health status, Great Britain, socioeconomic deprivation, inequality, For more than a century, British social research has used information about occupation to stratify the population. More recently, categorizations based on ethnicity or race have been used for similar [...]

The fair allocation of resources for health and social care in relation to the needs of the population in different parts of the United Kingdom has become particularly important since [...]

Federal and state governments in Australia have embarked on a series of national initiatives which show a firm commitment to tackling social inequalities in health. The development of national goals [...]

Abstract Objectives--To show that the exclusion from conventional class based analyses of child mortality of children whose parents are classified as 'unoccupied' produces a misleading picture of health inequalities. Design--Reanalysis [...]

The National Health Service has been at or close to the top of the political agenda since the summer of 1987. One sequence has been a plethora of polls and [...]

Introduction Whether the NHS will be able to cope in future depends largely on how far the NHS can control and respond to the pressures on it.[1 2] Arguments about [...]

The aims of health policy ought not to be contentious. Topping the list should be a commitment to improve the length and quality of life of everyone and to minimise [...]

Equity of access to health care on the basis of need alone is the central principle of the NHS. A corollary of this is that resources should be distributed among [...]

What is to be done about the system of American health care? Inequality is a feature of all health care systems; in the United States it is endemic. The world's [...]

Social Policy Research,Martin Bulmer (ed.), London, Macmillan, 1978, pp. 373, £5.95.Making Budgets,James N. Danziger, Sage Publications, 1978, pp. 255, £8.50 cloth edition and £4.25 paperback.Universality, Selectivity and Effectiveness in Social Policy,Bleddyn Davies (in association with Mike Reddin), Heinemann, London, 1978, pp. viii & 264, £9.50.Implementation in a Bureaucracy, Control in a Bureaucracy,Andrew Dunsire, Oxford, Martin Robertson, 1978, pp. Vol.1260, Vol. II 263, £15 each.Planning the Social Services,N. Falk and J. Lee, Saxon House, Farnborough, 1978, pp. x & 113, £7.50.Policy Analysis: A Political and Organisational Perspective,W. I. Jenkins, London, Martin Robertson, 1978, pp. 278, £8.95.Interactions and Interventions in Organizations,Iain L. Mangham, John Wiley & Sons, 1978, pp. 150, price not known.

Several letters to the editor are presented in response to articles in previous issues including a comment on the anti-smoking lobby's views on passive smoking, efforts by Singapore to curb smoking, and the smoking bans in Norway which included bars.

Background One of the successes of the National Health Service is that the distribution of general practitioners(GPs) corresponds much more closely to the size of the local communities than it did before 1948. However, more should be done to reflect the fact that different populations have variable needs for GPs. The aim of this paper is to estimate the relative need for GPs by linking evidence from individual utilization data to the characteristics of small areas. Methods Statistical models of GP utilization were developed from household survey data on 12 729 adults representative of the English population. The odds ratios derived from the models were combined with Census information for Family Health Services Authorities (FHSAs) to calculate a need indicator, which was used to estimate the number of GPs ‘needed’ in an area for comparison with the actual distribution. Results The utilization of GPs is associated with morbidity, demographic and socioeconomic variables. The needs indicator derived from the model of GP utilization varies from 1⋅66 to 2⋅40 with a mean of 2. Substantial changes in the distribution of GPs are required to reflect the relative need for them. For example, in relative terms, Cornwall and the Isles of Scilly has an excess of GPs of almost one-fifth whereas Rotherham has a shortfall of more than one-third. Conclusions The findings in this paper suggest that there are still considerable inequalities in access to GP services in England in relation to need.