The Resource Allocation Working Party and the NHS: Origins, Implementation and Development, 1974-1990

November 21st, 2013 Somerset House, London

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The focus of this Witness Seminar was the work of the Resource Allocation Working Party (RAWP).  Appointed by the Labour government in 1975, the RAWP’s work led in 1976 to the introduction of a new formula for distributing funding in the British National Health Service (NHS).  Henceforth it would be allocated according to measures of need, and not by the historical precedent which had hitherto favoured some regions more than others. Prior to the RAWP, the track record of Britain and of other Western nations in improving equality of access had not been impressive, despite decades of state intervention in health services.  Aneurin Bevan’s initial vision had been that the NHS would ‘universalise the best’, but thus far the goal had remained elusive.

Behind RAWP’s dry title and acronym then, lies a story which speaks to some central issues in the history of the NHS.  These range from the high idealism that has inspired the service, to the pragmatic and contentious political questions that attend reform efforts, to the technical but intellectually absorbing debates about how to achieve the fairest formula for redistribution.  The RAWP also deserves historical attention because it stands as an example of successful policy-making in the NHS.  Different views will be taken on how successful it was, and of course the postcode lottery debate is as live as ever.  Yet the RAWP episode instilled in the NHS the enduring policy goal of ‘equality of access to health care for people in equal need’.

Historical understanding of the RAWP is therefore important both to our understanding of the NHS and to the broader study of health systems.  The aim of the Witness Seminar was to examine this key episode, through the recollections of some of those involved at the time.

The meeting was jointly convened by the Dr Martin Gorsky ( Centre for History in Public Health at the London School of Hygiene and Tropical Medicine and Dr Virginia Preston ( of the Institute for Contemporary British History at King’s College London.  It was initiated and organised by the LSHTM Centre, supported by a Wellcome Trust grant ‘Witness Seminars in NHS History’.