Government response to the first report from the Health Committee: Priority setting in the NHS: purchasing (1995)

In its response to the Health Committee’s Priority setting in the NHS report on purchasing, the government agreed with the approach endorsed by the Health Committee (ie that there should be a separation between strategy and operational delivery) on how priority setting should be undertaken, noting that: ‘The task of giving strategic direction to the NHS falls legitimately within the domain of central government. But decisions involving local services should be made as close as possible to the patients and public they affect.’

The government recognised that demand was potentially unending and that priority setting would always be vital in the context of a finite budget.

The government did not want to establish national lists of treatments that would be funded and those that would not. However, the government outlined its intended approach for priority setting, namely that:

  • ministers would set out national priorities and targets for the NHS
  • health authorities and GP fundholders would assess local needs and decide, in consultation with the public, the treatments that were required
  • individual clinicians would decide on the most clinically appropriate treatment for each patient.


The principles of equity, efficiency and responsiveness would inform local decision making where there was a need to balance the needs of individuals and communities.

The government suggested that public involvement should play an important role in purchasing and pledged to promote future initiatives and guidance to promote this aspiration.

It noted that purchasing was a comparatively new role that was still evolving and the document outlined plans for the NHS to increasingly adopt an outcome-driven, evidence-based approach to decisions about the treatment of patients.