Rationing has put itself on the policy agenda following the government's health reforms in 1991 and has become a contentious and debated issue. All health services are inherently subject to some form of rationing because demand outstrips supply. In the British NHS there has always been rationing; the difference being that until recently it operated on an implicit rather than explicit basis and it was bound up with clinical judgements rather than purely financial assessments. This book identifies the numerous political and ethical issues surrounding rationing in healthcare. Drawing upon international examples, it offers a critical overview of the approaches to rationing and makes practical proposals for its management, including the revitalization of political and governmental institutions.