The NHS is not getting sufficient money to give us all what we want, but some cases are lucky and others are not. The reason is usually because of where they live. This cannot be right. We live in a country where everyone is equal until it comes to NHS treatment.

The so called 'post code lottery' is probably something which is endemic. The amount of money allocated to a Trust, the age of the population of that area, as much as mainly elderly. It would be a difficult decision to have to make but surely for the person involved there is no problem. As each of the following would surely say:

- If you are comparatively young and hoping for a family, the IVF treatment is a must.

- If you are comparatively young and hoping for a family and have breast cancer,life saving treatment is a must.

- If you have suffered with an arthritic hip for years an operation is a must.

- If you have dementia and can't look after yourself, help is a must.

Some people are given these treatments but others not, depending on where they live.

A headline in a daily paper "postcode lottery is killing 6,000 cancer patients every year". Very dramatic but not true, it is not the postcode that is killing patients but that some patients are not receiving the same treatment as others.  Cancer is individual to the person involved and treatment could be different in some patients to others, but our treatment should be the best possible available at the time. If you are elderly it could be said that you have had your life and possibly you should stand aside for treatment to be given for a younger person, but this should not be an issue, while there is a chance of good quality of life, treatment should always be offered regardless of the cost and where you live. However, if you are in a postcode that restricts treatment it could mean the difference between life or death and everyone should have the same chance of living.

Dept of Healh-Ministerial Correspondence and Publi Enquiries Unit:- The National Institute of Health and Care Excellence's (NICE) technology appraisal programme provides evidence-based guidance on the clinical and cost effectiveness of drugs and other health technologies. There is a legal requirement on the NHS to provide funding for treatments and drugs recommended by NICE technolgy appraisal guidance within three months of final guidance being publiches.  If NICE has not made a decision about a drug it is the responsibillity of the NHS locally to decide whether to commission it or not.  The Dept of Health has made it clear that it is not acceptable for the funding for treatments to be withheld simply because NICE has not yet published final guidance on them.  Where a drug or treatment has not been appraised by NICE or where negative guidance has been issued, funding decisions should be made by the relevant NHS commissioner, based on an assessment of the available evidence and on the individual patient's clinical circumstances.  The NHS Constitution states that patients have the right to expect local decisions on the funding of drugs and treatments to be made rationally following a proper consideration of the evidence.  If a commissioner decides not to fund a drug, then it should explain that decision. The Constitution right is supported by regulations that set out the legal requirements with which commissions must comply when making commissioning decisions.  If a patient's local clinical commissioning group or NHS decides, on the basis of rational, proper consideration of the evidence, that a treatment should not be provided that the patient and their doctor have requested, patients must be provided with the reasons for that decision in writing. NHS commissioners are required to have clear and transparent arrangements for local decisions making on funding of treatments and for considering exceptional funding requests.  Guidance can be accessed on the National Prescribibng Centre legacy website at www.npc.nhs.uk.




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