If you cannot get the service it is rationed. If you don’t know in advance, and especially if other can get it elsewhere in the UK, it is unfair.
Definitions are available: (HealthKnowledge), and Politicians do not understand it. (Think tank calls for NHS ‘devolution revolution’ framework) This suggests greater post-code rationing.
Dennis Cambell in the Guardfian 5th July 2016 warned: NHS finance chiefs warn of poorer care and longer waiting times – Rationing of services likely as hospital chiefs say they can’t make savings vital for reform and Sarah Bosely reported 28th July 2016: NHS ‘abandoning’ thousands by rationing hepatitis C drugs
Sam Lewis comments on “rationing” that the “Keyword here seems to be “reported”, since all US doctors ration health care according to cost, by definition of its payment regime. As indeed do all UK doctors by virtue of the implicit provision according to affordability, NHS or not. “Rationing” needs specific definition to make sense.”
Rationing can be explicit or implicit, can be covert or overt. In his book “In search of the perfect health care system”, Mark Britnell agrees that all health is rationed, and that most services are covert in their rationing.
The degree of rationing, and the honesty with which health is rationed is what interests me, and in this regard the “patient centred” health service should, in the view of NHSreality, use words and language that the public understand: not the language of the medical profession. Prioritisation, exclusion, restriction etc. are all methods of rationing, as are co-payments and excess (as in you pay the first part of a car claim). What seems to be honest is when patients are aware of what is not available, and acknowledge that this is a necessity in running any health system. Once this is agreed, then the debate on how to ration, and whether rationing should be income/wealth related can also be discussed. It is naïve to say as the Independent 2nd August “Time for the NHS to learn that prevention is better than cure”
And there are of course other calls on £20million: £20m funding gap in Sheffield’s flood defences and Ofsted pressure triggers £20m funding gap. In the real world difficult choice have to be made and we ask our experts on health boards and in central government to do this. But is remains covert and implicit rather than overt and explicit.
Laura Donelly in the Telegraph reports 8th August 2016: NHS rationing set to worsen in attempt to close £22bn funding gap – NHS treatments will need to be rationed and hospitals closed unless the health service makes unprecedented efficiency savings, a leading think-tank (Nuffield Trust) has said.
A new year. The Choice: Truth or evasion. Another election campaign without focus on the patient (“patient reported outcome measures”). More short termism, denial and political cowardice. No philosophy will be heard…