Equity and the NHS: self-reported morbidity,access, and primary care.

The patterns of access to primary health care for 27 154 people were examined, using the raw data of the 1974 General Household Survey about self-reported morbidity and use of services. Access rates were calculated for four categories of health: the not ill, the acutely sick, the chronically sick without restricted activity, and the chronically sick with restricted activity. Contrary to the conclusions of existing publications, the analysis shows that the NHS has achieved equity in terms of access to primary health care: there is no consistent bias against the lower socioeconomic groups and, in the case of some health care categories, these have proportionately higher rates of access than their rates of self-reported morbidity would indicate. The findings also show large variations in patterns of access both between and within these categories of health.     

Distribution of NHS funds between fundholding and non-fundholding practices.

OBJECTIVES--To estimate the amount spent on specific hospital care by health agencies in 1993-4 and compare it with the resources allocated to patients registered with fundholding practices for the same type of care. To investigate whether fundholding practices and health agencies pay different amounts for inpatient care. DESIGN--Examination of hospital episode statistics, 1991 census data, and family health services authority and health agency records. SETTING--Health agencies and fundholding practices in the former North West Thames Regional Health Authority. MAIN OUTCOME MEASURES--Amount per capita allocated to inpatient and outpatient care for patients registered with fundholding and non-fundholding practices. Average specialty cost per finished consultant episode for health agencies and fundholding practices. RESULTS--The ratio of per capita funding for patients in non-fundholding practices to those in fundholding practices ranged from 59% to 87% for inpatient and day case care and from 36% to 106% for outpatient care. Average specialty costs per episode were similar for fundholding practices and health agencies. CONCLUSIONS--Fundholding practices seem to have been funded more generously than non-fundholding practices in North West Thames.     

Cell cycle: bistability is needed for robust cycling

Xenopus egg extracts have distinct Cdk-active and Cdk-inactive states at intermediate cyclin concentrations, a phenomenon known as bistability. A new study shows that this behavior is important for robust cell cycling.