The north-south divide in England: implications for health care resource allocation

Published regional data show that the Standardized Mortality Ratio (SMR) for the northern half of England has recently increased from 113 to 115 per cent of the SMR for the south, and that the north is at least as disadvantaged in respect of morbidity and material deprivation and uses much less private medical care than the south. It is concluded that the north's share of National Health Service (NHS) resources should not be reduced, as it would be if recent proposals by the NHS Management Board were implemented; that a mortality index which gives different weights to deaths at different ages should possibly be used instead of the simple SMR to weight regional resource allocations for need; and that these allocations should also be weighted by some measure of the extent to which regional populations look to the NHS rather than to the private sector for hospital and specialist care.