Professor Alan Williams

Guiding light of health economics
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The Independent Online

Alan Williams was for over 40 years a Professor of Economics at York University. He was a fine scholar, a principled researcher and a stimulating teacher and lecturer, with an eclectic vision of the social sciences, and economics in particular.

Alan Harold Williams, health economist: born Birmingham 9 June 1927; Lecturer, Exeter University 1954-63; Senior Lecturer and Reader, York University 1964-68, Professor in the Centre for Health Economics 1968-2005; Director of Economic Studies, HM Treasury Centre for Administrative Studies 1966-68; FBA 2002; married 1953 June Porter (two sons, one daughter); died York 2 June 2005.

Alan Williams was for over 40 years a Professor of Economics at York University. He was a fine scholar, a principled researcher and a stimulating teacher and lecturer, with an eclectic vision of the social sciences, and economics in particular.

When asked about his hobbies, he would always include teasing. Wont to assail his colleagues and students with impudent notions of elegance and novelty, he also liked to tease us all into challenging and changing the status quo, both in academic ivory towers and in the corridors of Whitehall. His lifelong belief in the power of logic and economic analysis as an instrument for improving social welfare resulted in his producing radical and innovative work in local government finance, water regulation and, most importantly, in health economics.

Born in Birmingham, he was educated at King Edward's School there and, after graduating in Economics from Birmingham University, he spent some time studying the Swedish public finance literature. In so doing he forged links with colleagues who later, in 1977, recognised his contributions to economics by awarding him an Honorary DPhil from Lund University, where to his delight this honour was marked by cannon fire.

His first academic teaching post, from 1954, was as a Lecturer at Exeter University, where he did pioneering work on the economic theory of local government finance and produced a textbook, Public Finance and Budgetary Policy (1963), exhibiting prodigious and mind-boggling mastery of three-dimensional geometry.

Professors Sir Alan Peacock and Jack Wiseman recruited Williams to the new university of York in 1964. Wiseman's libertarian free-market approach contrasted nicely with Williams's egalitarian perspectives, creating a remarkable teaching environment for students and staff and occasioning Enoch Powell on one occasion to question how his libertarian colleagues could tolerate such socialists in their midst.

Williams's firm adherence to the view that the social sciences complemented each other and that an education in any one of the disciplines (economics, sociology and political science) required an appreciation of the interlocking perspectives, led him to support a five-term introductory social science education for new York students. This broad perspective dominated his work; he always sought multi-disciplinary approaches to ubiquitous social issues such as health-care rationing.

In 1966, Williams was seconded to the Treasury as Director of the Centre for Administrative Studies. During this period he was dispatched to the Ministry of Health to inject some economic rigour into hospital planning processes. He found no evidence of planning when he arrived in the ministry, but met some intriguing physicians, including Professor Archie Cochrane, who later pioneered the evidence-based medicine movement, and Professor Sir Douglas Black, who chaired a report on health inequalities. His exchanges with them convinced Williams that much of medical practice and health-care planning was evidence-free and a suitable subject for analysis by a principled economist fully supportive of the principles of the NHS.

He returned to York and focused on the economics of the water industry, while continuing to work in health and maintaining his contacts with Cochrane and Black. His teaching remained in public finance where he inspired generations of graduate students. However, over the 1970s he was increasingly seduced by the challenges of the NHS and its role as a means of improving the health of the British population. He became the guiding light of health economics not just in York, but nationally and internationally. His "corruption" of many fine young minds created an international York "mafia" of health economists.

Alan Williams's work with the Merrison Royal Commission on the NHS in the late 1970s frustrated and exhausted him but provided the launch pad for his most famous work in health economics. His pioneering work on the measurement and valuation of health underpinned his advocacy of the concept of the Quality Adjusted Life Year (or QALY) as the best outcome measure in healthcare priority setting. This is now the central element of the work of the National Institute for Clinical Excellence.

In the last decade, Williams focused on the integration of equity concerns into cost-effectiveness analysis. In his seventies he argued with groups of senior citizens, advocating discrimination in favour of the young in NHS rationing. His concept of the "fair innings" suggested that those who had experienced this luxury should give up resources to fund the care of the young.

Alan Williams encouraged generations of students and academic colleagues to tease out better solutions to the problems facing their societies, in particular their healthcare systems. He never intimidated and always brought new perspectives to the intriguing problems that populate not only the funding and provision of healthcare, but also the broader issues of improving population health by redistributive policies outside the NHS.

In 2002, he was the first health economist to be elected a Senior Fellow of the British Academy.

Alan Maynard

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