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Abstract

In this paper we consider the role of the Test Discount Rate, as recommended by the UK Treasury, in the NHS. We do not intend to discuss the mechanics of discounting. Rather the purpose of the paper is to consider some of the theoretical difficulties associated with the practice of discounting in the public sector generally and the NHS specifically, in the light of the officially endorsed rationale for the use of the TDR in the UK. We believe that the mechanics of discounting are generally well understood in the NHS but that there is little understanding of the theoretical justification for this practice in the health care sector. We therefore believe that this is giving rise to a less than optimal use of the discounting procedure in allocating resources in the NHS.

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References

Committee of Public Accounts , (1980-81), Report 17, (HC 255), (HMSO, London).

Committee of Public Accounts , (1982-82), Report 28, (HC 417), (HMSO, London).

DHSS , (1979), Review of Health Capital, (HMSO, London).

DHSS , (1982), Appraisal of Development Options in the Health Service, (HMSO, London).

Feldstein , M. S. , (1973), ‘The Inadequacy of Weighted Discount Rates’, in Layard, R., Cost-Benefit Analysis, (1972), (Penguin, London).

Goodin, R. E. , (1982), Discounting Discounting, Journal of Public Policy, Vol. 2, pp.53-72.

Heald, D. , (1980), ‘The Economic and Financial Control of UK Nationalized Industries’, Economic Journal Vol. 90, pp.243-265.

Henderson, P. D. , (1965), ‘Notes on Public Investment Criteria in the United Kingdom’, Bulletin of the Oxford University Institute of Economics and Statistics, Vol. 27, pp.55-89.

Pearce, D. W. and Nash, C. A. , (1981), The Social Appraisal of Projects: A Text in Cost-Benefit Analysis, (Macmillan Press, London).

10.

Rees, R. , (1976), Public Enterprise Economics, Weidenfeld and Nicolson, London).

11.

HM Treasury , (1967), Nationalized Industries: A Review of Economic and Financial Objectives, Cmnd. 3437), (HMSO, London).

12.

HM Treasury , (1978), The Nationalized Industries, (Cmnd. 713 1), (HMSO, London)

13.

HM Treasury , (1979), The Test Discount Rate and the Required Rate of Return on Investment: Government Economic Service Working Paper No. 22, (HMSO, London).

14.

HM Treasury , (1982), Investment Appraisal in the Public Sector, (HMSO, London).

15.

Webb, M. G. , (1973), The Economics of the Nationalized Industries, (Nelson, London).

16.

Webb, M. G. , (1980) A Critical Appraisal of UK Government Control of Nationalized Industries, University of York Discussion Paper No. 37.

The Role of the Test Discount Rate in the NHS

Abstract

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