Sailing without radar: an excursion in resource allocation.

This paper deals with the knowledge base employed in resource allocation. It deliberately distinguishes between 'thick-textured' and 'thin-textured' knowledge. A thick-textured view of change in the health sector accounts for the history, civic goods and variety of human needs and passions which rationalist economics defines out as a thin-textured matter of individual choices in a free market. The narrative material begins with a discussion of health service policy-making in South Australia and elsewhere in the 1980s and 1990s, then proceeds to a discussion of priority-setting literature, which we regard as thin-textured. We offer two accounts of approaches to setting priorities in health care which we think have overcome some of the deficiencies of the thin-textured approach.