This concluding chapter brings together some of the major problems facing health care resource allocators by re-considering the debate as to the proper locus of decision-making in the NHS, the issue of trust in the NHS, and the potential for conflict between private rights and public interests. The modern solution to the problem in judicial review is to leave the final decision-making responsibility firmly in the hands of those appointed to do so within a fair and consistent framework. The first step in developing a fair and consistent approach to health care resource allocation is for government to make a more candid contribution to the limitations inherent in the way one chooses to fund the NHS. Until government can discuss the subject more openly, local decision-makers will find it hard to convince patients that rationing is really necessary.
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