Distributive Justice and Rationing in the NHS: Framing Effects in Press Coverage of a Controversial Decision

Abstract

Despite moves towards more openness over the allocation of treatment in the National Health Service (NHS), the public remains dependent upon the media for most of its information. This paper concerns the issue of rationing and how this was represented in newspaper articles following a controversial decision by a health authority to withhold a particular treatment from a 10-year old girl suffering from leukaemia. Relevant articles on this issue from a cross-section of newspapers were subjected to analysis using the method of Grounded Theory. Three major themes emerged: (i) the criteria for allocating treatment; (ii) who should make the decisions; and (iii) the consequences of transparency in the context of the current ‘market’ ethos in the NHS. Views diverged depending upon how the issue was framed, with some taking a patient-centred perspective and others emphasizing the dilemma of priority-setting. Some welcomed greater transparency, but for others this underlined the incompatibility of two distributive domains, namely, the delivery of care and compassion vs. the more ‘rational’ cost–benefit calculations associated with the economic domain. Overall, the tone of debate was at a fairly superficial level with little consensus about how to begin to address these issues. © 1997 John Wiley & Sons, Ltd.

Cite this work

No public copy is stored for this record, so only the metadata is cited.

Stored only when both papers are in the corpus — 14 citations exist upstream.

Papers that cite the same references — the relational fallback while embeddings are still backfilling.