The knee jerk response of commissioners to the “rules of the game” is to hit the softest targets. Those who don’t or wont speak out, the psychiatrically ill, those with limited prognosis and rare diseases. They hope that their votes, and those of their family won’t be significant compared to the majority who live on demanding Everything for everyone for ever. Unfortunately the future means this will get worse… And these are of course post coded inequalities as a result of covert decision making.
Theresa May has been urged by charity chiefs to stop the NHS rationing treatment for seriously ill patients and to find more money for their care in the budget next month.
About 30 health charities, including the Teenage Cancer Trust, National AIDS Trust and Motor Neurone Disease Association, have raised the alarm about NHS England “restricting and rationing treatment” because of underfunding, especially for patients with rare and complex conditions. The groups from the Specialised Healthcare Alliance said this rationing is taking place without sufficient public scrutiny.
In a letter to the prime minister, they said NHS England is “choosing to restrict and ration treatments that patients with rare and complex conditions need – often without proper consultation with patients”. “We hope that you will take action to ensure full patient involvement in these decisions, and to ensure that any decision to ration treatment is overseen by democratically elected politicians,” they added.
The warning comes after health thinktank the King’s Fund said that politicians would be escaping culpability for rationing decisions, as plans due to come into force from April mean that even cost-effective treatments could be denied to patients.
Nicholas Timmins, a policy adviser at the organisation, wrote: “If the NHS can no longer fund new and cost-effective treatments, ministers should announce that decision case by case, and be held accountable for so doing”.
It emerged last month that cancer, diabetes and asthma patients could all be hit by the new affordability criteria, which means that drugs which cost the NHS more than £20m in total each year could be subject to restrictions.
The charity chiefs also raised wider concerns about funding for the NHS, which medics have said is under huge pressure this winter because of cuts to adult social care provided by councils.
Philip Hammond, the chancellor, is facing calls to give more money to the NHS next month after resisting an emergency bailout at the autumn statement. Instead, the government has launched a long-term review of social care and will allow councils to raise more through a local ‘precept’ (an extra charge to council tax bills which can only be used for adult social services) in the next couple of years.
No 10 and the Treasury appear to remain firmly against repeated calls from medics and the opposition for more cash for the NHS, indicating they are not prepared to change tack at the budget. But the charities say: “Our charities – and the patients we represent – are deeply concerned by the recent statements of Simon Stevens concerning the NHS’s relative underfunding. We urge you to ensure that this year’s budget provides the NHS with the funding it needs to deliver the standards of care patients expect.”
The charities issued their warning ahead of a Lords debate on the medical supplies bill this week, which Labour’s shadow health minister Lord Philip Hunt has described as a missed opportunity to “get rid of many of the restrictions on NHS patients using innovative new medicines”. A government spokesman said blanket restrictions on treatment are unacceptable and that the clinical needs of a patient, and the urgency with which they require treatment, must come first.
“The government is responding to the needs of the NHS by investing more money – £4bn this year – to fund its own plans for the future”.