System level decisions around the commissioning and provision of healthcare services in England have contributed to barriers in accessing the NHS. In this article, we ask how to better regulate resource allocation to ensure greater equity in access to healthcare services. First, we focus on the Health and Care Act 2022 which, drawing on principles of deliberative regulation to address health inequalities, initiates a shift away from previous regulatory approaches towards a collaborative decision-making model. We then shed light on the systemic factors creating and maintaining access barriers by considering shortcomings in previous regulatory approaches. With these in mind, we consider whether deliberative regulation - providing communities with resources to create normative solutions to intrinsic issues - could help address these systemic challenges. To assess the potential of laws or policies to achieve greater equity in healthcare, we also introduce an evaluative framework based on deliberative principles. We apply this framework on a case study of an Integrated Care System to gauge the extent to which the Health and Care Act 2022 has indeed been effectively adopting a deliberative approach by intentionally engaging marginalised communities in decision-making and devising accountability mechanisms for the allocation of healthcare resources.
Harnessing Deliberative Regulation to Address Inequities in Accessing Healthcare Services in England
Gianluca Veronesi
2024-01-01
Abstract
System level decisions around the commissioning and provision of healthcare services in England have contributed to barriers in accessing the NHS. In this article, we ask how to better regulate resource allocation to ensure greater equity in access to healthcare services. First, we focus on the Health and Care Act 2022 which, drawing on principles of deliberative regulation to address health inequalities, initiates a shift away from previous regulatory approaches towards a collaborative decision-making model. We then shed light on the systemic factors creating and maintaining access barriers by considering shortcomings in previous regulatory approaches. With these in mind, we consider whether deliberative regulation - providing communities with resources to create normative solutions to intrinsic issues - could help address these systemic challenges. To assess the potential of laws or policies to achieve greater equity in healthcare, we also introduce an evaluative framework based on deliberative principles. We apply this framework on a case study of an Integrated Care System to gauge the extent to which the Health and Care Act 2022 has indeed been effectively adopting a deliberative approach by intentionally engaging marginalised communities in decision-making and devising accountability mechanisms for the allocation of healthcare resources.File | Dimensione | Formato | |
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Germain and Veronesi 2024 MLR Harnessing deliberative regulation to address health inequities accepted version.docx
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