A National Doctor Morbidity Survey

Of the many problems which have dogged the Health Service since its inception, one basic one, never properly Addressed, has been that of assessing the demand for health-care. Looking at the level of provision over the Population as a whole has not been helpful. Attempting 0 do this has revealed the inadequacy of the machinery 0r measuring what those who provide health-care are Actually engaged in doing. To think that measuring the evel of provision would be helpful in deciding what ought to be provided is a fallacy unless we know what he target is, and how far short we fall. Since British Medicine falls short in many respects of what is provided 'h other comparable countries, we do not know whether he differences are important or merely reflect the different financial arrangements for medicine and the motiva'ons which flow from these. Since the difference in h^edical expenditure per head, for example, between the USA and the UK is approximately three-fold, both these Countries cannot be right, given that the measurables (e9-operations performed per unit of population) roughly reflect the financial differences. We certainly need some j^easure of what levels of health-care provision should e provided, so that we can, when our measurement sVstem can be brought up to scratch, have some idea of ^hat has to be done to achieve that level for the whole of ?Ur population. Unless this can be done soon, we shall hever conquer the inequalities in the distribution of ealth-care over our country which the RAWP machinery ^as meant to try and alleviate. Twenty-five years ago I spent a year in an African eaching hospital which was surrounded by a high im-