<?xml version='1.0' encoding='UTF-8'?><xml><records><record><source-app name="HighWire" version="7.x">Drupal-HighWire</source-app><ref-type name="Journal Article">17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Watt, Graham</style></author></authors><secondary-authors></secondary-authors></contributors><titles><title><style face="normal" font="default" size="100%">The inverse care law revisited: a continuing blot on the record of the National Health Service</style></title><secondary-title><style face="normal" font="default" size="100%">British Journal of General Practice</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2018</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2018-12-01 00:00:00</style></date></pub-dates></dates><pages><style  face="normal" font="default" size="100%">562-563</style></pages><doi><style  face="normal" font="default" size="100%">10.3399/bjgp18X699893</style></doi><volume><style face="normal" font="default" size="100%">68</style></volume><issue><style face="normal" font="default" size="100%">677</style></issue><abstract><style  face="normal" font="default" size="100%">‘The availability of good medical care tends to vary inversely with the need for it in the population served.’ 1The monstrous longevity of the inverse care law, almost half a century after it was first described in the UK NHS, reflects poorly on politicians, NHS management, and professional organisations, all of whom regularly assert their opposition to inequalities in health and health care. As Tudor Hart observed, ‘intellectual opposition to injustice is only the beginning of social understanding’.2In his later years, Tudor Hart regretted having coined a term that had entered the vocabulary but had not led to effective action.Tudor Hart’s original essay emphasised that the inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced. Commercial medicine takes money out of the system; does not pay for the training of the staff it employs; excludes patients who cannot pay; avoids complexity whenever it can; panders to the worried well; and over-provides in terms of investigations and treatments. It promotes social exclusion at both ends of society, excluding patients who cannot pay, and affluent patients who no longer have a stake in a shared system.The introduction of the NHS is often commemorated as if it were a battle, like Waterloo, at which a national enemy was defeated for all time. A better analogy is a Dutch dyke, keeping the sea at bay. If the dyke is not maintained, …</style></abstract></record></records></xml>