8 September 2008

Additamentum 8 September 2008

The King’s Fund has published a study Update to local variations in NHS spending priorities1. Details are here. This looks at the differences in adjusted per head spending by 152 primary care trusts in England on specifics such as cancer. There are disturbing variations in the levels of spending which are not fully explained yet and which I think are probably unjustified. The study reveals a postcode lottery in healthcare. In the study Cornwall and the Isles of Scilly trust is in the lowest quartile for spending on cancer and mental health and in the third quartile (the next to best) for spending on circulatory and heart problems. This is poor news for people in the first two categories who need help. It raises sharply the need for the advocates of localism to develop an effective answer to the postcode lottery aspect of localism.

The continuing news of local differences in the NHS raises questions. In what sense is a primary care trust local? How far can local people influence its decisions? Should the treatment you get depend on where you live or should there be national standards and requirements of treatment?

Original article 4 September 2008
Another example of what localism means in the world people live in: read the distressing story here and here. A man with cancer is denied expensive treatment by his local primary care trust. If he lived a few miles away he would get the life-extending medication because the neighbouring trust agrees it.

There are serious questions that the advocates of localism should answer. Is a post code lottery all right? If not, what do the advocates mean by localism?

These are my previous posts on localism:

A simple principle in Cornwall

If you can’t do it right, make it shiny

Localism in Cornwall: update