Even thought the NHS is free at the point of use it is not equitable.
It shares with othe countries evidence of differences in cancer survival.
[1] Patients who are deprived are less likely to receive major treatments
for cancer especially if they live at a distance from specialised
facilities [2]. The effectiveness of rationing within the NHS as a means
by which equal access to diagnosis and treatment is attained must
therefore be questioned.
The NHS defines the size of its resources cake, or rather this is
decided by HM Treasury. There is then an attempt to design services around
the sharing of that cake. This differs from countries where clinicians
provide a service and then charge the State for doing so, or charge the
patient who seeks reimbursement from the State. The effect of this is that
NHS patients are in effect competing with each other for resources; the
rôle of doctors is to adjudicate that competition.
Since affluent, educated people are undoubtedly more effective
competitors than others the tendency to regard use of the NHS, rather than
privately-funded healthcare, as a moral obligation means that for a given
health need socioeconomically deprived people have less resource available
to them than would be the case if the affluent “went private.”
Perhaps the philosophy that discourages the private financing of
healthcare needs to be revised.
References
1] Woods L. M., Rachet B. & Coleman M. P. Origins of socio-
economic inequalities in cancer survival: a review
Annals of Oncology 17: 5–19, 2006
2]. Jones A.P, Haynes R., Sauerzapf V. Crawford S.M., Zhao H.,
Forman D. Travel time to hospital and treatment for breast, colon,
rectum,lung, ovary and prostate cancer EUROPEAN JOURNAL OF CANCER 44; 992
–999. (2008)
Rapid Response:
Benign rationing or fierce competition?
Even thought the NHS is free at the point of use it is not equitable.
It shares with othe countries evidence of differences in cancer survival.
[1] Patients who are deprived are less likely to receive major treatments
for cancer especially if they live at a distance from specialised
facilities [2]. The effectiveness of rationing within the NHS as a means
by which equal access to diagnosis and treatment is attained must
therefore be questioned.
The NHS defines the size of its resources cake, or rather this is
decided by HM Treasury. There is then an attempt to design services around
the sharing of that cake. This differs from countries where clinicians
provide a service and then charge the State for doing so, or charge the
patient who seeks reimbursement from the State. The effect of this is that
NHS patients are in effect competing with each other for resources; the
rôle of doctors is to adjudicate that competition.
Since affluent, educated people are undoubtedly more effective
competitors than others the tendency to regard use of the NHS, rather than
privately-funded healthcare, as a moral obligation means that for a given
health need socioeconomically deprived people have less resource available
to them than would be the case if the affluent “went private.”
Perhaps the philosophy that discourages the private financing of
healthcare needs to be revised.
References
1] Woods L. M., Rachet B. & Coleman M. P. Origins of socio-
economic inequalities in cancer survival: a review
Annals of Oncology 17: 5–19, 2006
2]. Jones A.P, Haynes R., Sauerzapf V. Crawford S.M., Zhao H.,
Forman D. Travel time to hospital and treatment for breast, colon,
rectum,lung, ovary and prostate cancer EUROPEAN JOURNAL OF CANCER 44; 992
–999. (2008)
Competing interests:
None declared
Competing interests: No competing interests