Richard Vize reports in the Guardian 24th April 2015: Rationing care is a fact of life for the NHS , but the average patient does not know this, until they need a service. It’s one of the toughest issues the health service has to face, but it should be debated openly, honestly and without political interference.
This week’s survey by HSJ revealing that 39% of clinical commissioning groups it contacted were considering rationing care to save money in the coming year highlights one of the murkier areas of health policy and raises a number of difficult questions.
Rationing is nothing new, of course. When waiting lists stretched to many months and even years, treatment was often rationed simply by the patient dying before they reach the operating table. Heart surgery was a striking example of this. The long waits in A&E departments acted as another form of rationing.
Labour’s all-out assault on waiting lists and eventual introduction of the 18 weeks referral-to-treatment target ended this backdoor workload management system. Now the NHS Constitution gives the impression that clinical need and conformity with Nice guidelines are all that stand between the patient and treatment, while the purchasing decisions of commissioners should ensure that any rationing is open to public scrutiny.