In 1997, to help commemorate 25 years of health economics, experts were invited to nominate articles or books that they thought had been most influential in the field. The eventual winner was a paper by Alan Williams, professor of economics since 1968 at the Centre for Health Economics at York University, who has died of cancer aged 77.
Alan's vision, forensic intellect and leadership are key reasons why health economics in Britain has evolved into such a powerful sub-discipline of economics. He was instrumental in setting up the York centre and its graduate programme, which were milestones for the subject and its wider success. With an unrivalled ability to engage specialists on their own ground, and an eye for weakness in any argument, Alan helped engineer a sea change in the way healthcare decisions are made.
Paradoxically, Williams's paper on the economics of coronary artery bypass grafting, recognised as most influential in 1997, had been published in 1985 by the British Medical Journal and drew the attention of clinicians to his work. Williams's views centred on the way that healthcare impacted on both the quantity and/or quality of life, and he advocated "quality-adjusted Qaly) as a measure of health benefit. This had far-reaching consequences, arguably up to and including the creation of the National Institute for Clinical Excellence (Nice) in 1999.
The central issue for Alan was that of determining a way of valuing health that could be used in evaluating the cost-effectiveness of healthcare. In 1991 the Measurement and Valuation of Health (MVH) Project was commissioned by the then Department of Health and Social Security, and it remains the landmark study of its type.
The objective of the project was nothing less than the creation of a nationally representative set of values for health collected from around 3,400 members of the public. So systematic was the attention to the detail of its design that it has been replicated in several countries since its completion.
Williams was born in Ladywood, Birmingham, son of a licensed victualler, and educated at King Edward's school, Birmingham. After Royal Air Force national service from 1945 to 1948, he took a BCom from Birmingham University. This was followed by postgraduate studies in Uppsala and Stockholm.
From 1954 to 1963, Williams was a lecturer in economics at Exeter University. He was also a visiting lecturer at Massachusetts Institute of Technology from 1957 to 1958 and at Princeton from 1963 to 1964, the year that he made the decisive move to York, as a senior lecturer and reader in economics.
From 1966 to 1968 he was seconded to the Treasury as director of economic studies at its centre for administrative studies. This eventually brought him into contact with other creative thinkers, including the then director of the Medical Research Council's epidemiology unit at Cardiff, the late Professor Archie Cochrane, and Rachel Rosser, whose pioneering research in health status measurement he helped adapt for use in economic valuation.
It was his appointment to the Royal Commission on the National Health Service in 1976 which provided Williams with direct access to clinicians and managers. Unsurprisingly, his resignation in 1978 arose on a matter of principle and a dispute on the role of researchers working for the commission.
From York, Williams encouraged and nurtured a global network of academic and professional colleagues. This led in 1987 to him convening a fateful meeting in Rotterdam that marked the formation of what became the EuroQoL Group. He challenged his colleagues to work out how value for health might be measured and how variations in such values might be studied across different countries. This was an ambitious task for a small but dedicated group for whom the only common denominator was Williams himself.
Nearly 20 years on, the group is a thriving research enterprise that has developed as an extended family around its founder. EQ-5D, the measure of health status developed by EuroQoL, has been translated into more than 80 languages, and is now the de facto standard in many countries. The group's success and the robustness of the personal and professional relationships within it were a continuing source of pride for him.
In recent years, Alan entered into a high-profile disagreement with those at the World Health Organisation and elsewhere who proposed alternatives to the Qaly. More significantly, he looked at the ethical issues around healthcare priorities, espousing the "fair innings".
Based on the notion that everyone feels entitled to a normal span of health - imperfectly represented by a life expectancy of, say, three score years and 10 - the concept reflects the feeling that people have of being cheated if they fail to achieve this goal. Death at 25 is viewed very differently from death at 85. Entitlement to health care ought, he felt, to take account of such differences in perspective. As he put it himself, once his own prognosis had become clear, "as an advocate of the fair innings argument I can hardly complain". But he admitted that the timing was "rather inconvenient", since there was so much more to be done on a research agenda that he himself had helped to write.
He loved opera, and, surprisingly, particularly liked the sound of the trombone - for him, the Ryedale or Buxton festivals took priority over academic engagements. He greatly enjoyed walks in interesting countryside - and confessed to a more than passing expertise on the subject of windmills.
Many academics may privately aspire to changing society, but few do, even those who become fellows of the British Academy, as Williams did in 2002. Alan Williams succeeded in that aspiration.
In his parting testimony, he observed that "the best you can hope for is that enough of your colleagues will regard your findings as a working hypothesis that they are willing to accept until something better comes along". Sage advice from an academic always open to persuasion on the basis of evidence - even if his office door did carry the slogan: "Be reasonable - do it my way".
He is survived by his wife June, a daughter and two sons.
· Alan Harold Williams, health economist, born June 9 1927; died June 2 2005
