Am I the only one who feels a bit queasy every time I see a poster in a shop window promoting the Health Lottery? Not, until recently, because of any opinions about the rival claims of this organisation and the National Lottery (in fact, I have only just realised that there are different operations going on here).
It just seems to highlight everything that is wrong, and probably going to get worse, about our national health service. If you Google for NHS lottery, you will get a mixed bag of results, some relating to the aforementioned game of chance, others to the variable health service available, depending on where you live.
To save us all the trouble of finding out for ourselves, the government has produced an NHS Atlas of Variation. If you assumed that someone with dementia would have access to the same treatment in Kent as Lancashire, you would be wrong. NHS funding for a care home place for someone who requires continuing care? Much less likely in the West Country than Northumberland. If you need bariatric surgery, the East Midlands is a better bet than East Anglia. These are just a few highlights. The analysis was based on 71 key indicators, including hospital admission rates, treatments that Primary Care Trusts choose to fund, mental health provisions, cancer treatments, etc, and it shows wide differences that cannot be explained by variations in patient illness or patient preferences.
Add to this recent stories in the media highlighting poorer treatment received from the NHS by people with learning disabilities, with dementia, and those with physical disabilities, and "health lottery" really does seem to sum it up.
During the past week, organisations representing nurses and midwives joined doctors in confirming their opposition to the proposed changes to the NHS: people at the sharp end seem unanimous in fearing that however well-intentioned, expecting GPs to take on commissioning of health services will make outcomes even more variable. As funding available for the NHS continues to be squeezed, and the private sector is allowed to take over those areas where they see scope for turning a profit, again, it will be the patients who pay the real price. Expect the recent spat between private cosmetic surgery clinics and the government about responsibility for putting right dodgy breast implants to be repeated multiple times, as entrepreneurial set-ups find the cost of dealing with unforeseen consequences unacceptably high.
Health Lottery indeed. Incidentally, the other Health Lottery is either a clever collaboration between 51 community interest companies (CICs) intended to generate more funds from the public for health-related causes, or an attempt to persuade people away from the National Lottery - which apparently gives a higher percentage of the ticket price to the causes it supports - thus reducing the amount of money available to good causes in general. There is some debate about the ethics of the situation, amongst MPs, third sector organisations, and other interested parties, including the Gambling Commission.
The bottom line, though, is that we all have a choice about which, if either, of the lotteries we choose to support. When it comes to the NHS, there is only one, and when we need its services, we really have very little choice in the matter.
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The NHS no longer lets GPs like me offer routine operations http://alturl.com/ecw6q Too many doctors etc.. are disagreeing with this statement.
ReplyDeleteBut as patients know, the GP power/ability to obtain for their patients what they feel is best for them is disappearing. These days it’s the power brokers that make the decision, all many GPs can do is submit a request. This is resulting in a colossal post code lottery. if you live in an area that health is good you are more likely to receive the extra treatment, if you live somewhere like say Rochdale where funds are short to the amount deprivation then you are not likely to receive the funding.
The other major worry is, that the people making the decisions are the doctors that act as clinical directors etc.. being a patient rep on one of these committees worried me, I see doctors making vital life changing decisions, that just 18 months ago the majority of requests were approve where now they are not. How can GP/Clinicians be nonaligned with their colleagues, its clearly a post code lottery nationally, but even locally there a huge danger it a post code lottery due to people knowing how asking. So for patients with needs, move to an area where health is good (if you can afford it) ensure you sign up to a local doctor that sits on the PCT panel making major choice decisions.
This is not a request for the old system to come back but for a far one for all, the old system was flawed, what one person has everyone should be entitled to it subject to need
visit us at http://www.facebook.com/Patientswatchdog#!/groups/126857600752378/?notif_t=group_activity
I think the point you are making supports the view that we seem to have developed a Regional Health Service rather than a National one. In addition it seems individual Trusts are able to suspend areas of activity, such as A & E, leaving the local population with little or difficult access.
ReplyDeleteI just don’t see how the moving of commissioning to local GP’s ensures a level playing field across England and Wales and ensures good access by all to services.
Surely the intention of the NHS is to provide the same level of care to all people in all areas.
ReplyDeleteThe notion of better care for well funded areas (read that as not deprived areas) with poorer funded areas and services potentially getting support from the Health Lottery strikes me a driving a larger wedge between those that have money and those that don't.
I live in Tunbridge Wells and our local hospital has just been re-opened as a new, super modern unit with private rooms for each patient and the very latest technology and facilities. We were one of the first parents to try out the birthing facilities and whilst they were all very lovely, as you would hopefully expect, the surprising thing that I found out in between trips to the birthing pool was that some other parents to be were apparently travelling over 2 hours to this unit, whilst in full labour, because of their dissatisfaction with their own local postcode facilities.
ReplyDeleteI guess it's impossible to standardise facilities throughout the country (how can you upgrade everything all at the same time, especially within the current economic climate), but within the same breath you can't expect the general public to not try to get the best for themselves wherever possible and what about the large percentage of the population who aren't able to play the system or push their own needs....it's not the way things should be but what's the alternative to re-organising our vast, archaic systems on a tightening budget?
This happens all the time in social care systems as well. To me this seems even more unfair but maybe I'm biased towards the area of the healthcare profession I find myself working within on a daily basis....
Well, NHS for the patients is getting harder by the day no doubt. I guess the squeeze on the budget along with the raising medical expenses are the cause.. It is eventually the people who will have to pay for any additional cost. However, when it comes to play health lottery, it seems comforting to know 20% of my ticket is going into helping the NHS and local communities there after. It's a huge topic of debate raised here, but a brilliant and compelling one. Really enjoyed reading it.
ReplyDeleteWhen reading articles about competition between the Health lottery and the National Lottery I can't help but think if both of these lotteries are offered to the millions of people playing the lottery what's the problem of having them both? They both support charities and good causes and some people will prefer one to the other but if they're both benefiting causes who need the money then it's a positive factor.I just need to match the Health lottery results http://uklotterynews.wordpress.com/ now so I can get the benefit!
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