Managing Scarcity: Priority Setting and Rationing in the National Health Service

Rudolf Klein, Patricia Day, Sharon Redmayne /Open University Press, £13.99, pp 161/ISBN 0 335 19446 X How should individual doctors rank the needs of the different patients they encounter? In daily practice my endeavours feel very imprecise. I attempt to allocate my time roughly in proportion to the level of patients' distress and the complexity of their problem. If there is too much to do, I ration, mostly by dilution–I spread myself a little thinner, giving a little less to everyone but probably in much the same proportions. I strive not to close the door completely on anyone because to do so is to belittle their distress and their fear. At least …