You never knew it was “unavailable” until you needed it.. and then it’s too late

The public as a whole, or body politic, remains in denial, along with the politicians about rationing. News items this week, and in the last few months, reveal that you never knew it was “unavailable” until you needed it…. Politicians allow money to be spent on unproven issues like screening the middle aged, outsourcing privately to their own companies, and yet still covertly ration ambulance and IVF services. How long before there is a private ambulance and emergency service option? It will have to happen as standards fall further..  Bringing back fear rather than replacing it…? The perverse incentive to win votes rather than care for the young (who don’t vote), the demented and elderly is evident.. A perverse incentive is a driver within a system that works against the overall intention of the system.. How much better to ration overtly?


BBC News 131sth Jan 2016: Why postcodes are determining fertility treatment

IVF in numbers: 50,000

women have IVF every year in UK: 40%

of treatment funded by NHS

  • Number of cycles women should get on NHS: 3
  • Number of CCGs offering this: 18%
  • CCGs charge per cycle: £1,300 – £6,000

National Infertility Awareness Week 2016: Why Choose IVF?

Kate Pickles for Mailonline 2nd May 2016 reports: Couple forced to pay £8,000 for IVF treatment after hairdresser goes through early menopause at just 23

The Telegraph 2nd November 2015: Women denied IVF as 80 per cent of NHS trusts ration fertility treatment

More than 80 per cent of NHS trusts are denying women three cycles of fertility treatment despite national guidelines

Nothing has happened since 22nd Nov 2014 when: NICE calls for an end to postcode lottery of IVF treatment

Cheddar Valley Gazette March 06, 2016 reports: Childless couples in Somerset face IVF treatment rationing

BBC news 29th October 2015 IVF costs to NHS ‘must be capped’, says fertility expert

14th Feb Maionline: NHS rationing of hearing aids fuels epidemic of Alzheimer’s

12th March 2016: NHS smear test rationing ‘is costing young lives’, leading doctor warns 

Leeds and West Yorkshire post reports 5th May 2016: Pontefract Hospital failings led to boy’s stillbirth….

Margaret McCartney: How to misspend £2.4bn (2016;353:i2366 )

Chris Smith et al report in the Times 11th November 2014: GPs award £2.4bn deals to their own companies 

BBC News 5th May: North East MPs express fears over health of ambulance service “…one constituent who had to wait more than six hours before being taken to hospital to be treated for a bleed on the brain.”

BBC News 15th February 2016: Diabetic woman died after five-hour ambulance delay



This entry was posted in A Personal View, Perverse Incentives, Post Code Lottery, 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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