What is the justification in "post code" treatment within the NHS?

Question

What would be a more reasonable alternative

Answer 1

I don’t think I can justify it but I think might be able to understand how it happened.

I don’t think it was a deliberate - it just happened through circumstances.

Apparently, there are now 10 SHAs (Strategic Health Authorities) and within those some 152 PCTs with an average of about 330,000 people (i.e. potential patients) per PCT – this is after Patricia Hewitt’s surgery on the NHS in 2006.

Before there were 28 SHA’s and 303 PCT’s.

PCTs have their own budgets and set their own priorities, within the overriding priorities and budgets set by the relevant SHA belong to, and Department of Health. (sources NHS website and Wikipedia).

The original SHAs areas closely followed the county map for England with a few smaller counties merged into one – the new SHAs look more like the maps for the ill-proposed Regional Assemblies – surely just a coincidence!

(I can just imagine the glee when John Prescott and Patricia Hewitt worked this one out together!)

http://en.wikipedia.org/wiki/Strategic_H...

Of course these are only lines on a map and due to the reorganization they are now only redrawn lines on a map with no real foundation in fact - or indeed any resemblance to the populations that make up the SHA and this by definition must extend to the PCTs within the SHAs.

This means that there can be two adjacent PCTs with radically different resources

(hospitals, training hospitals etc), a similar population but with different patient profiles.

The spending of the PCTs will of course have different patterns because the resources.

For instance, in an industrial/mining area (or ex-industrial as so often seems to be the case these days) there would tend to be a higher number of cases of asbestos-related disease and associated cancers whereas in the neighbouring, outlying, PCT there would be fewer.

There may be fewer but there might be a ‘spike’ in cases and there have been many examples of ‘clustering’ of diseases in areas where they might not usually be expected.



In this case the outlying PCT would not have the budget to fund the treatment of this ‘spike’.

The real problem is not a post-code lottery but a PCT funding lottery – although I will concede that it could get to such at GP level.

As to the alternative - apparently Alan Johnson has the solution - well he has announced an end to the post-code lottery.

I can’t wait to see – there’s been a deafening silence since his announcement.

Surely, he wouldn’t have made an announcement without thinking it through would he?

Answer 2

There is no justifiable need for the post code lotery within the NHS. The reasonable alternative would be to half the hospital managers to free up more moeny for to use for treatments and drugs.

Answer 3

The reasonable alternative would be to sack 95% of health managers who are all scroungers, and force the remaining 5% to do their jobs properly.

Then you get a government with an ounce of integrity to stop using the service as a political football and restore to....well...a service!

Answer 4

there is no justification at all. We all pay into it, and should receive equal treatment. As someone said sack many of these bloated so called Managers and put the money back where it belongs, in treating the people

Answer 5

One of the original tenets of the Health Service was equal health for all, to lose sight of that goal can't bode well. These arguments need to be thrashed out publicly by those at the coal face, not faceless committees behind closed doors, we hear too much of these overpaid managers who, even when they fail, walk away with huge payoffs.

Answer 6

No justification as such, but the cause is that Primary Care Trusts receive their budget directly from the government and are then subject to "performance monitoring" ,thus each PCT decides on it´s own criteria to meet the government demands resulting in differences in standards of care and services throughout the country.

The answer....centralised decision making based on health rather than monetary grounds.

Answer 7

No justification at all , because far too many people are just walking into the Country and head for the nearest Hospital, to get treated with all the diseases they bring in here.  They should be made to pay and also take their turn on the waiting list. There is a lot of people who have paid all their life into the NHS, and a lot never use it, including myself, but if I had to, I would probably have to even wait to get to see a Doctor. and that could take months. The NHS wants a shake up but not by these idiots in Parliament, but by a Board solely made up with us the People, and to change it every year for fresh blood to come into it with more fresh ideas.