Inverse Care Law

The inverse care law was suggested thirty years ago by Julian Tudor Hart in a paper for The Lancet, to describe a perverse relationship between the need for health care and its actual utilisation. In other words, those who most need medical care are least likely to receive it. Conversely, those with least need of health care tend to use health services more (and more effectively). Inverse laws are of course commonplace, and essentially arise because of income inequalities. In most areas of life (politics of envy aside) most of us are reasonably happy with this state of affairs. The fact that the rich have more clothes than they strictly 'need' is not too great a cause for concern. But the fact that an inverse law applies to health care offends against most people's views about fairness - a view which forms the basis for the existence of the NHS.