"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 N HS, little attention has been given to patient's perceptions of rationing a nd the potential impact this might have on people's use of services. Drawin g on the qualitative findings of a study conducted in the North West of Eng land which was concerned with the pattern and processes of primary care hel p seeking, this paper sets out to examine perceptions and experiences of ra tioning in primary care and the potential impact this has on people's use o f services. In relation to primary care services people had experienced rat ioning by deterrence, dilution and delay. There was some evidence that perc eptions of rationing impacted on help seeking and the use of primary care s ervices. The implications for understanding the way in which perceptions of rationing might influence the formulation of demand and help seeking by pe ople using primary care services are discussed.