"If a patient is too costly they tend to get rid of you:" the impact of people's perceptions of rationing on the use of primary care.

Despite the increasing focus on rationing, and rationing decisions in the NHS, little attention has been given to patient's perceptions of rationing and the potential impact this might have on people's use of services. Drawing on the qualitative findings of a study conducted in the North West of England which was concerned with the pattern and processes of primary care help seeking, this paper sets out to examine perceptions and experiences of rationing in primary care and the potential impact this has on people's use of services. In relation to primary care services people had experienced rationing by deterrence, dilution and delay. There was some evidence that perceptions of rationing impacted on help seeking and the use of primary care services. The implications for understanding the way in which perceptions of rationing might influence the formulation of demand and help seeking by people using primary care services are discussed.