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Britain's National Health Service (NHS) is a universal, single-payer health system in which the central state has been instrumental in ensuring equity. This article investigates why from the 1970s a policy to achieve equal access for equal need was implemented. Despite the founding principle that the NHS should "universalize the best," this was a controversial policy goal, implying substantial redistribution from London and the South and threatening established medical, political, and bureaucratic interests. Our conceptual approach draws on the advocacy coalition framework (ACF), which foregrounds the influence of research and ideas in the policy process. We first outline the spatial inequities that the NHS inherited, the work of the Resource Allocation Working Party (RAWP), and its new redistributive formula. We then introduce the ACF approach, analyzing the RAWP's prehistory and formation in advocacy coalition terms, focusing particularly on the rise of health economics. Our explanation emphasizes the consensual commitment to equity, which relegated conflict to more technical questions of application. The "buy-in" of midlevel bureaucrats was central to the RAWP's successful alignment of equity with allocative efficiency. We contrast this with the failure of advocacy for equity of health outcomes: here consensus over core beliefs and technical solutions proved elusive.

Summary. The Vaccine Damage Payments Act 1979 provided a lump-sum social security benefit to children who had become severely disabled as a result of vaccination. It came in the wake of a scare over the safety of the whooping cough (pertussis) vaccine. Yet very little has been written about it. Existing literature focuses more on the public health and medical aspects of both the Act and the scare. This article uses material from the archives of disability organisations and official documents to show that this Act should be seen as part of the history of post-war British disability policy. By framing it thus, we can learn more about why the government responded in the specific way that it did, as well as shed new light on public attitudes towards vaccination and disability.

In 1956, the British Ministry of Health instituted a vaccination programme against poliomyelitis, but run into myriad supply and administrative issues. When Coventry experienced an epidemic in 1957, it came to symbolise these problems. Throughout, it was claimed that the government lacked 'common sense' . This article explores how and why 'common sense' was used as a rhetorical weapon in the debates over policy at the local and national level. While those claiming 'common sense' were often at odds with medical and administrative authorities, the arguments were often informed by deeply held beliefs about vaccination and disease.In the summer of 1957, Coventry became the subject of national attention when an outbreak of poliomyelitis 1 struck the city. A series of supply issues had led to a shortage of the new polio vaccine, and many who had registered their children for immunisation were yet to receive their course of injections. Worse, the Ministry of Health refused to divert vaccine from non-epidemic areas to help deal with the crisis, or even to import extra supplies from abroad. Over July, August and September, the press made a series of accusations about government incompetence at the local and national levels, claiming that this was an avoidable tragedy. Many of the criticisms would feel familiar to observers across the post-war period in Britain. The Ministry was, apparently, too bureaucratic, putting procedure above people's lives; the medical authorities were not quick enough to arrive at concrete solutions to various problems as they arose; more than that, the experts were crippled by a lack of 'commonsense' . 2 This article examines how these issues manifested through the debate over polio vaccine supply in the city of Coventry. It focuses on two main questions. First, why did the Ministry of Health refuse to redirect vaccine to Coventry and other epidemic areas to help manage the outbreak? Second, in the face of a nationwide shortage, why did the national government refuse either to seek foreign supplies or to accept offers of help from abroad? To explain this, government papers and press articles are examined at the national and local level, and placed into the wider context of public health at this time.