From Oxford: NHS: "there is a need for rationing...illustration of the ant colony is fitting"

Lancet. 2013 Dec 21;382(9910):2065-6. doi: 10.1016/S0140-6736(13)62690-2.

Morality in the NHS marketplace.

Gilbert BJ¹, Maruthappu M², Leaver L³, Gray M³.

Author information

• ¹University of Oxford, Oxford OX2 6HG, UK. Electronic address: barnabas.gilbert@gtc.ox.ac.uk.
• ²Harvard University, Cambridge, MA, USA.
• ³University of Oxford, Oxford OX2 6HG, UK.

"For the NHS to retain its moral credibility, it must remain patient-centric, considering patients as pivotal members of clinical teams—eg, through open access to patient records. The market focus should be exchanged for one of collaboration, in which commissioners, patient representatives, and providers seek to work together. In recognising that not every health-care need can be met, there is a need for rationing, whereby benefits and burdens are fairly distributed. Hölldobler and Wilson's illustration of the ant colony is fitting: just as ants cooperate within their own colony but compete with new colonies when they are introduced, so must individual health-care providers learn to cooperate within a wider setting of competition, without an inherent need for a hierarchy or a market.5"