Priority setting for health equality - searching for an ethical framework

Area of Science:

• Public Health Policy
• Health Economics
• Bioethics

Background:

• 14 years of public welfare austerity have exacerbated health equality challenges.
• Recent policy mandates integration between National Health Service (NHS) bodies and local authorities to address health equality.
• This integration complicates the existing difficulties in NHS resource allocation.

Purpose of the Study:

• To examine the complexities of NHS resource allocation due to integrated public health and local authority services.
• To argue for the necessity of a new legal framework for public health priority setting.
• To explore ethical, political, and practical challenges in setting public health priorities for health equality.

Main Methods:

• Review of current priority-setting approaches in medical treatment.
• Analysis of existing ethical frameworks' responses.
• Application of an intersectional lens to public health priority setting.
• Utilizing Professor Sir Michael Marmot's framework for reducing health inequalities.

Main Results:

• The integration of NHS and local authorities introduces significant new difficulties in resource allocation.
• Current ethical frameworks are insufficient for addressing public health priority setting challenges.
• A new framework is needed to evaluate values, evidence, and criteria for public health priorities.

Conclusions:

• A new legal and ethical framework is essential for effective public health priority setting to achieve health equality.
• Addressing health inequalities requires innovative solutions, such as an intersectional approach.
• The findings underscore the need for a robust system to guide public health resource allocation in light of policy changes.