Understanding fear is the key… The lottery of fear… unequal treatment for equal taxpayers

Its pure demographics. The longer life expectancy means that “fear” of post coded differences in treatments, investigation and operation waiting, and in care during terminal illness or palliate treatment is a reality. Fear of unequal treatment for equal taxpayers is not a good recipe for a contented population, especially in rural areas at a distance from tertiary centres. Understanding fear is the key. Citizens may continue to demand locally based services despite lower standards because of fear.. The lottery of fear is getting worse. Mr Hunt needs to re-read Aneurin Bevan: In Place of Fear A Free Health Service 1952 Chapter 5 In Place of Fearcropped-nhs-lottery-play-here1.jpg

Scotland.BBC News 20th Feb: Macmillan warns of cancer ‘survival gap’ in Scotland

N Ireland. The Belfast Telegraph on St David’s Day warns: Researchers warn of postcode lottery in care for the dying

Wales. The BBC reports 22nd Feb a trend which is universal to the UK: Cancer cases in Wales rise by 10% in 10 yearsBBC News but we have known this since 2011: Cancer cases projected to rise 45% in next two decades …

Whilst advances have been made in most cancers, not so for the lung. Today the results are little different to 2011: Lung cancer ‘still biggest cancer killerin Wales … – BBC

Lucy Fisher in The Times on St David’s Day reports: Rural areas lose in ‘unfair’ funding of elderly care

Rural councils receive 60 per cent less money for social care per elderly resident than those in London, because of an “unfair” cash formula, a study says.

The County Councils Network (CCN), a pressure group representing England’s shire authorities, has condemned “regressive, unfair and opaque” Treasury methodology. Counties received £279 in social care funding for each resident over 65 in 2013-14, according to a study by LG Futures.

This compares with £717 for London councils, £590 for metropolitan boroughs and £449 for non-county unitary authorities.

Since then, funding has fallen by 20.1 per cent between 2013-14 and last year, but funding for London authorities fell by 17.6 per cent, CCN said.

The gap is widening, the pressure group says, because the elderly population is increasing at a faster rate in the shires than in cities. Between 2015 and 2020 the number of over 65s is likely to increase in rural areas by 2 per cent a year. The national average is 1.8 per cent a year.

This growth will increase the burden on rural councils by an estimated £247 million. County councils have had to raise more money locally to pay for care and have often put up council tax beyond the level of inner London councils for the same band properties.

The CCN said that the local government funding formula, which calculates the central money allocated to social care and other services, uses out-of-date demographic data. It is calling for a “cost-driver” approach that would focus on population and infrastructure pressures.

Last week the government confirmed that a review of local government funding would be completed by 2019-20. County councils and Conservative MPs with shire seats are putting pressure on ministers to ensure that specific challenges relating to social care and other services in rural areas are reflected in the funding formula that results from the review.

Last week James Heappey, Conservative MP for Wells, called on Sajid Javid, the communities secretary, to pledge that any additional funding for elderly care would be allocated according to a needs-based formula that recognised, with appropriate weighting, sparsity of population and a deteriorating demographic: issues in rural areas.

Paul Carter, chairman of the CCN, and the Conservative leader of Kent county council, said: “The prime minister quite appropriately wants to create a ‘society that works for everyone’. However, the method of funding local government clearly does not pass the fairness test for everyone and this has a profound effect on county residents.”

He wants more funding for social care in the budget next week and said he hoped that the funding review would lead to a fair and equitable solution to “glaring discrepancies [in funding] . . . rather than the current regressive, unfair and opaque methodology”.

A government spokesman said that it had “provided a further £80.5 million for rural authorities through the rural services delivery grant”.

Advanced directives needed. Choice in death and dying. Lord Darzi warns of “draconian rationing”. GPs need to be involved at the interface of oncology and palliative care.

Cancer care not good enough in eight out of ten regions

“..a brutal and potentially fatal form of healthcare rationing”. It should be the politicians with “an inability to face the outside world” rather than the patients..

To talk of a 'postcode lottery' is absurd...Sometimes we can't find the postcode...and then we have to make up a different rule

To talk of a ‘postcode lottery’ is absurd…Sometimes we can’t find the postcode…and then we have to make up a different rule


This entry was posted in A Personal View, 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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