Hospital Provision before the NHS: Territorial Justice or Inverse Care Law?

Abstract

ABSTRACTIt is often claimed that before the NHS areas with the highest need for health care had the least provision. In other words, it is asserted that the so-called ‘inverse care law’ (Hart, 1971) existed. This claim is empirically tested for the hospital sector, using needs and provision data from a number of sources. It is found that, for the voluntary hospital sector, both beds and staff were inequitably distributed. However, for the municipal hospital sector, it appears that high need areas tended to have more beds and staff than low need areas. When both sectors are aggregated to produce total provision there is little association between need and bed provision, but inequitable provision for staffing. Thus, it is concluded that municipal provision was successful to some extent in rectifying the inequitable nature of voluntary provision.