National(not) Health Service

I confess to being a bit of an admirer of the way in which Boris conducts his politics but this hits the nail on the head. Interesting to see how New Labour will reply seeing as they all voted for devolution, are all scots and are getting old. Also, living across the pond, everyone seems jealous of the NHS considering the obscene costs of the US health care system - not so green after they read this article from Telegraph 31 Aug

D Telegraph online
He fails to mention, though, the piling debt of the Scottish Executive and the excessive moneys owed by the Scottish NHS that makes my LHA's debt look like sofa change.

It's one thing to look at some one else and decry the unfairness of the haves over the have-nots, but to do the same thing and to never consider the price of it is just lazy thinking.
When Boris cries injustice over the 'postcode lottery' within his constituency, he should pause to consider who makes the decision as to which drugs are and are not available within the PCT...

...his constituents! In addition the the 'executive' members of the PCT board, the majority of the board is composed of 'non-executive' members who are local 'lay persons'.

He should have a chat with them and ask why this drug is not selected for use in the region.

The same is true for the england/scotland issue, and yes the scots are up to their sporrans in debt!

Not that I'm a Blair apologist, but the truth is the truth. I work in the NHS and for however much sh!t goes on there, it's doing a fantastic job. A little less beurocracy and a little more trust of the staff's clinical reasoning would go a long way though!
Of interest what is the problem with deciding what drugs are approved and used centrally? For once centralisation looks a good idea (until someone who knows the system tells me why it isnt)
Un-Friendly-Fire said:
Of interest what is the problem with deciding what drugs are approved and used centrally? For once centralisation looks a good idea (until someone who knows the system tells me why it isnt)
The problem with centralisation is that different regions suffer differing levels of illness based on a variety of factors. If you centralise this, then regional needs are often lost in the process.

Similarly, centralisation causes health prevention and outreach programs to lose out as they are lost from the list of national priorities.

One such exanmple is heart disease which is often prevalent in depressed industrial/post-industrial areas amongst the working classes. If a centralised decision making policy was implemented, richer areas suffering lower incidences of heart disease would be inundated with resources to fight an illness that isn't their biggest killer.

Not the best example, but it illustrates the point.

Futher to this, if you centralise the decision making process, but allocate resources based on need, then what was the point of centralising the process in the first place?
Notwithstanding the political and local constituancy bias of Mr Johnson's article, I agree with Un F F's observation - why can't we have central policy? My wife worked in the NHS (at quite a high level) for many years before following the flag over here. She often came home shattered from meetings debating funding of services in her PCT whilst 'next door' PCTs were awash with cash. The recent realignment of PCTs was also a lottery as many saw it as a way of bailing out poorer Trusts. Decentralisation doesn't seem to be working in the NHS but what is the alternative? A large bureacratic department of state with associated waste? Or privatisation...?
Decisions are made centrally, hence the advice by NICE that this drug not be offered.

Imagine the centrally sanctioned options as a pick and mix for the PCTs to choose what suits them best. The idea is that local areas can tailor their budget to suit their community. For example the needs of a rural farming area differ from inner city and again from ex-coal working towns etc.

It's great in theory and works well in practice for the most part, especially where service provision to the community is concerned. However, the media is never happy and people will forever bend the facts to suit their agendas. Those in power will cock things up and those in opposition will just moan...

Chalky, heart disease is higher in certain areas but the need for prevention strategies and treatment provision is somewhat universal. Generally because we are increasingly a nation of fat bastards who wont get of our arrses to do the minimum of exercise and bother to eat healthily.

Heart failure has a higher prevelance than cancer, a worse 5 year mortality and is (arguably) more debilitating. Yet we do not hear the media inerviewing fat people in the streets asking why they intend to waste tax payers money on their health care. If we reduced the incidence of heart disease in the UK significantly, we wouldn't be having this discussion about funding!

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