You are a manager in the Health and Social Care Trust. You have been given £1,000,000 and you must decide how to spend it. These are your options:

Extra funding for mammography services. All women will not be screened yearly for breast cancer. Previously this screening service was only for women over the age of 50.

Extra funding for hip replacements. Waiting times for a hip replacement will drop from 18 months to 6 months.

Extra funding for a new drug for a rare heart condition. It may extend their lives by up to 12 months.

Extra funding for all teenage girls to receive a new vaccine. This vaccine will reduce risk of cervical cancer by 10%.

This is a classical medical ethics question regarding Resource Allocation. There is no right or wrong answer to questions like this. The examiner/interviewer wants the candidate to demonstrate that they can logically think through a problem, present a balanced argument and come to a justified decision.

Answer Structure:

-Refer to the ‘4 Pillars of Medical Ethics’ – “This is a question regarding Justice, where there is prioritisation in the allocation of resources. Everyone must be treating equally.”

-Go through each option. Give an advantage and disadvantage.

-Speak about Quality Adjusted Life Years (QALYs) in your argument. This is how many extra years of life at full health- who will benefit the most?

-Finish with your decision. –“Based on the points I have spoken about I believe…”