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The debate is polarised between the view that decisions over rationing should be more explicit, systematic and democratic, and those who argue that such strategies are unrealistic and fail to understand both how the NHS actually operates and the complex nature of its objectives.  In this important contribution to the debate, the authors suggest a way forward which acknowledges the realities of delivering health care within the NHS, while seeking to improve the way in which hard choices are made.  The book also examines some of the different types of rationing initiatives which have been tried in recent years.  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