Exploring distributive justice in health care. Aust Health Rev 2001;24:40–4

The allocation of resources to providers and the way in which the resources are then prioritised to specific service areas and patients remain the critical ethical decisions which determine the type of health system a community receives. Health care providers will never be given enough resources to satisfy all the demands placed upon them by a community that is becoming increasingly informed and demanding. This paper discusses the matter of justice as it relates to the distribution of health resources. It translates the theoretical constructs of distribution into a practical situation that arose at The Geelong Hospital. It is important to emphasise that the aim of giving the example is not necessarily to provide the right answer but rather to assist in determining what ought to be the questions. An ethical dilemma in resource allocation The Geelong Hospital is the second oldest hospital in Victoria, Australia, and has a proud tradition of service to its local community. In an environment of economic rationalism, the Hospital received budget cuts that accumulated to over 14%, in real terms, over the period 1994 to 1999. By necessity, the Hospital underwent substantial restructure with workplace reform being an important feature. The Hospital’s capacity to absorb further cuts has diminished and it is regarded as a most effective and efficient performer. The ethical dilemma for the hospital is in determining how to deal with the increasing service demands bein