• Nicola Waldron.
• Department of Research and Clinical Effectiveness, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath.
• Br J Nurs. 2006 Mar 9; 15 (5): 286-91.

AbstractThis article examines current research, literature and government policy that influences how health funding is allocated for treatment and care of the chronically sick. Chronic disease represents a huge burden of ill health in the UK and a substantial cost to the NHS. With both an increase in the ageing population and advancing technological developments giving doctors the theoretical ability to sustain the most fragile life, the issue of providing unlimited access of care to the chronically sick within financial limitations is clearly untenable. This article explores the issue of funding the needs of the chronically sick while posing a significant challenge both politically and financially to the healthcare system. It examines the controversial policies of rationing implemented by various governments since the conception of the NHS. Some have proved unworkable, all have been controversial, and still the challenge remains to provide a comprehensive care package with limited resources. The issue of how to ration resources to the chronically sick remains unresolved. Social gerontologists predict that living to 120 years of age may become the norm before the end of this century. Exploitation of the genome map and society's unwillingness to accept the inevitability of disability resulting from chronic illness will further increase pressure on healthcare financing and, as a result, demands will be forever increasing despite the most rigorous attempts at rationing.

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