THE INVERSE CARE LAW
The NHS was introduced in Britain in 1948 to provide equal access to health care to everyone in the UK. It has offered ‘ a comprehensive national service, available to all, free at the time of use, non-contributory, and financed from taxation.’ 1 However, Julian Tudor Hart (1927–2018), who was a GP working in Wales, observed that the healthcare availability and the population that needs it have an inverse correlation relationship.1 As factors that contribute to the inverse care law, Tudor Hart suggested that market forces working on primary-care services led to an inequality of health care between the wealthy and the poor.1
Tudor Hart argued that the inverse care law is expressed in the lack of availability of healthcare services. Wyszewianski and McLaughlin define availability as, ‘The extent to which the provider has the requisite resources, such as personnel and technology, to meet the needs of the client’.2
According to Tudor Hart, doctors didn’t prefer to work in poorer or more working- class areas unless they had social and familial ties.1 People living in such areas at the time, such as miners, tended to work in dangerous and dirty environments and end up with major diseases. Doctors in such areas were supposed to care for patients with less money (funding) even though doctors in more affluent areas could earn more money looking after patients who were less sick and fewer in number. Tudor Hart further observed that the working environment of doctors in deprived areas was poor, but doctors in middle-class areas enjoyed better equipment and resources.1
Availability of health care is meaningless unless people can access it. Wyszewianski and McLaughlin define accessibility as, ‘how easily the client can physically reach the provider’s location’.2 Tudor Hart found there were expanding list sizes …