Rationing continues covertly, but the better aspects of overt rationing are ignored by the media.

In the last week the following news item shows how the media can dumb down an issue, and how the nuances of health (Wilsons Criteria) pass them by. Cancer of the cervix kills fewer and fewer, and those who die are mostly those who have had 3 or more pregnancies and over the age of 35. This does not mean that the screening fails for those under the target age, but it is a population measure, and the utility value decreases as the target group gets younger, Most young sexually active women <25 will not refuse a smear, so why not offer them one opportunistically? Then there is the issue of payment – why not charge for all tests for everyone except those who have never had one? Rational rationing is essential if we are to save OUR health services. And what about the men? Abdominal USS is a one off and seems to be one of the most cost effective screenings..

Rationing your fair share

Fiona Macrae in The Mail 12th March 2016: NHS smear test rationing ‘is costing young lives’, leading doctor warns

n2004, 5 minute smear tests were scrapped for 20-24 year olds. Since then the number of cervical cancer deaths of young women has soared

Consultant gynaecologist Angus McIndoe says NHS rationing is to blame

But the NHS argues that the disease is rare in those under 25 years,

Save Money – stop Screening? Even Wilson and Junger expected revisions… and genetic information may allow us to be more targeted.

The role of the high street health specialists in screening and The Information Age: “as the circle of light increases, so does the circumference of darkness”.

The difference between “association” and evidence, between relative risk and absolute risk. Money spent on mammography screening might be better spent elsewhere.

One PSA is not a screening test. Serial PSAs are a good indicator but they have not been sanctioned..

The Worried Well – we need to start rationing out screening tests for those with means to pay

Call for lung cancer screening in UK – an inappropriate waste of money

“It’s counterintuitive.”Government should revue Value for Money of Health Checks and Screening in general

The politics of health.. The Lemmings of the left leave a vacuum where Mr Stevens’ debate will not happen… Are we all lemmings as far as our health system is concerned?


This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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