City Research Online

Will COVID-19 Mark the End of an Egalitarian National Health Service?

Germain, S. ORCID: 0000-0003-2697-6039 (2020). Will COVID-19 Mark the End of an Egalitarian National Health Service? (City Law School Research Paper 2020/05). London, UK: City Law School, City, University of London.


The exceptional circumstances brought about by the COVID-19 pandemic have affected the traditional organisation of healthcare resources allocation in the United Kingdom. Since its inception the NHS has aimed to regulate risks of ill health in the population by providing an equal and universal provision of health care services to residents based on their health status rather than their ability to pay. This paper argues that the current government’s emergency healthcare policy in response to this pandemic has however favoured a utilitarian approach to healthcare rationing and potentially initiated the end of an egalitarian NHS.

The paper first unpacks why the allocation of healthcare resources is fundamentally a question of justice in Britain and explains why healthcare law and policy require a philosophical approach in times of crisis. Secondly, the paper provides a critical analysis of the current situation for the allocation of healthcare resources and the provision of services to patients directly or indirectly affected by the virus. It concludes that values of equality in access to care at the heart of the NHS are in jeopardy and are being replaced by a utilitarian approach based on a priority ranking of patients in this time of crisis.

Publication Type: Monograph (Working Paper)
Additional Information: © The Author(s), 2020. Published in final form by Cambridge University Press - Germain, S. (2020). Will COVID-19 mark the end of an egalitarian NHS?. European Journal of Risk Regulation, 11(2), pp. 358-365. doi: 10.1017/err.2020.33. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD61 Risk Management
K Law > KD England and Wales
Q Science > QR Microbiology > QR180 Immunology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: The City Law School > Academic Programmes
The City Law School > CLS Working Paper Series
The City Law School > International Law and Affairs Group
[thumbnail of CLS WP 2020 05 SG EJRR.pdf]
Text - Accepted Version
Download (598kB) | Preview


Add to AnyAdd to TwitterAdd to FacebookAdd to LinkedinAdd to PinterestAdd to Email


Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login