Monday, October 30, 2006

Can you end the NHS postcode lottery without ending the NHS?
On Wednesday in Parliament, Joan Ruddock MP for Lewisham Deptford reminded the Prime Minister about the Government wish to do away with the NHS postcode lottery. She stated the case of a constituent that had finally got the State to pay for the cancer drug Herceptin. But can you end the lottery while leaving the NHS intact?

In the space of six years, nothing has changed despite the increase in NHS investment. In the year 2000, the public first learnt that their cancer mortality rate depended on where they lived. Dr. Peter Hawker of the BMA then dismissed such statistics. A chief criticism was that certain hospitals took on more risky cases, incurring a volatile profile as a result. Another was that social deprivation had an impact (see my blog of October 25). Roll on 2006. The King’s Fund, an independent charity looks at the issue again. Only this time, adjustments are made for local conditions and needs. The study for the year 2004-5 found spending on cancer services could vary by as much as three per cent of the local budget in one area to seven per cent in another. Daventry and South Northants spent £132 per person on cancer treatments while Heart of Birmingham Teaching PCT spent £35. Oh, and there was no quote from the BMA on supposedly dodgy statistics.

It seems to me that the postcode lottery is a function of central control, totally immune to liberal amounts of investment. If local needs must drive local service then it cannot be achieved with national targets for a so-called `whole service’: The two are totally incompatible because different parts of the country are, well, different to each other, and therefore have different needs. It may require nothing less than a full break up of the NHS…

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