David Lock writes in The Guardian 4th April 2014: Rationing NHS care: why we need a serious debate – NHS reality agrees. Only after the honest debate on rationing begins will professionals become engaged again. Once we have honesty, we can then start to remove fear from speaking up…
The NHS is not spending our tax money effectively. There is a wide professional consensus that too much is being spent on hospital buildings it cannot afford, and it is failing to reduce spending on drug treatments that do not work. But many local NHS leaders are too frightened to try and persuade the public of the case for change. Reforms are delayed for fear of upsetting politicians who seek re-election.
Rationing healthcare treatments to control costs is regarded as an explosive issue in politics. In America, congresswoman Michelle Bachmann stated that the idea of treatment cost being taken into account, and sometimes withheld due to financial reasons, would be a “horrific notion to our nation’s doctors”.
In contrast to this political rhetoric, in the law courts it is accepted that rationing is part of the healthcare business. The supreme court of the United States approved paying doctors to ration care, saying that there must be “some incentive connecting physician reward with treatment rationing”. In the UK, the court of appeal has similarly held that it is lawful for the NHS to ration access to healthcare. Political, not legal, constraints hold back NHS reform and the losers are vulnerable patients who don’t get the treatment they need, while money is wasted on hospitals that are not justifiable and services of marginal benefit.
Nigel Lawson observed that “the NHS is the closest thing the English have to a religion”. Yet, as with all religions, informed debate is clouded by myths………….