Official URL: http://www.nuim.ie/nirsa/research/pdf/WPS03.pdf

In Ireland as in many other countries, much health care provision is State funded and State provided. Equity, in the sense of equality of 'treatment' for individuals with the same health needs irrespective of their geographical locatins, or incomes, has been, and is, very much stressed as an appropriate policy objective. However, health care delivery in Ireland (and in some other countries included the UK) operates through reginally based Health Boards responsible for provision in their own regions. This implies mechanisms for funding allocations to Boards that allow for the corresponding regional needs, but the choice of mechanism is not at all a simple or non-contestious topic. It is important though, and so a very appropriate topic for research by the National Institute for Regional and Spatial Anallysis. This Working Paper is at least a first step in a relevant investigation. Following much research, formulae have beeen developed in the UK for the allocation of health care funding across regions with the ofjective of attaining regional equity in health care. The formulae employ criteria such as regional populations, age and gender distributions, and regiional morbidity and socio-economic measures. The UK work is a natural starting point for corresponding Irish formulae. So one theme of this paper is a critical review of the UK's formulea and assessing how the system has actually worked in Northern Ireland. However, we think it is also important to critically examine the apparent primacy granted to the objective of equality attainment. As regards the first theme, we conclude some assumptions are implausible and some issues unresolved and we disscuss the implications should a formula based regional allocatin strategy be desired for Ireland. As regards the second theme, we find that healthcare equity - in spite of the primacy in many minds - is an elusive entity, very hard to measure, let alone achieve. Making it a primary objective in health care provision carries a price as regards attainment of other objectives and this, alone with its elusiveness, deserves consideration by helath economists and policy mak