Gordon Brown promises to end NHS postcode lottery

Exclusive by Vincent Moss, Political Editor 29/06/2008

Gordon Brown (Pic:Getty Images)

Gordon Brown will tomorrow vow to end the postcode lottery blamed for the deaths of thousands of NHS patients.

The PM will make the pledge as part of celebrations this week to mark the 60th anniversary of the NHS.

Together with Health Secretary Alan Johnson, he will unveil a draft NHS constitution to give patients new legal rights about the quality of the care they receive from its £90billion budget.

The move follows criticism that some patients have died after being denied lifesaving drugs freely available in other parts of Britain.

Charities have condemned the stark differences, which have seen some NHS trusts spend eight times more on care for cancer, heart or mental patients than trusts just a few miles away. Now Mr Brown will vow to end the postcode lottery and delays of up to three years before new drugs are made available to patients.

The new law, which will only apply to England, is part of Health Minister Lord Darzi's review of the NHS to turn the system into a worldclass health service.

Mr Johnson said the plan would deal with patients' "perceived postcode lottery". He admitted patients felt "there are too many variations in who gets access to prescribed drugs".

But he insisted: "The draft constitution will make it explicit that patients have the right to NICE-approved drugs and treatment if clinically appropriate."

Mr Johnson also vowed to slash the time it takes before new drugs are fully licensed and available to patients, from three years to a few months.

And he promised that trusts would have to give "clear and transparent reasons" if they failed to pay for drugs.

Health chiefs will also have to publish death rates to expose variations in the quality of care. And patients will also get a legal right to choose where they are treated.

A spokesman for the Patients' Association said: "We welcome anything that ends the postcode lottery, but some trusts are already struggling and without more cash they could end up being legally held to account for drugs they cannot afford."

WHAT IT MEANS..

What is the postcode lottery?
Local doctors and hospitals were given control of their own budgets when the internal market was introduced into the NHS in the mid-1990s. This resulted in random variations in the provision of treatment around the country. If you live in the "wrong" area you may not get the same service as in a neighbouring district.

What does it mean to patients?
It affects provision of expensive medicines, cancer treatments, access to IVF and waiting lists. In extreme cases, patients have been denied lifesaving drugs - such as cancer treatments Tamoxifen and Herceptin (right) - even though they are approved by medicines watchdog National Institute for Health and Clinical Excellence (NICE) or are awaiting approval.

Who is affected by it?
Generally, the poorer the area, the worse your care is likely to be.

Primary care trusts in deprived areas are more likely to have a lot of calls on their money, and budgets with spending limits on specific drugs. But costs will vary-regionally depending on the survival age and profile of communities.

What is the Government going to do about it?

Ten years ago Labour promised a "one-nation health service". It introduced national standards and NICE, which makes decisions on the effectiveness of new drugs for the whole country.

Now Alan Johnson is going to insist that health trusts deliver on that promise. His new constitution for the NHS will spell out patients' legal right to treatments.

The gran: Maureen Barnes, 62
Maureen is fighting for her life after her local primary care trust refused to pay for a drug available everywhere else in the country.

After a long battle to be prescribed a drug called Alimta she is now in a hospice with deadly lung disease mesothelioma, barely able to breathe.

Maureen, a greatgrandmother, from High Peak, Derbyshire, was diagnosed with the asbestosrelated condition at the end of 2006.

At the same time Alimta was recognised by NICE as delaying the progress of the disease, and primary care trusts began to prescribe it.

But Derbyshire PCT refused to pay the £1,500 cost of a course.

Outraged, she and husband Fred, aged 72, got 6,000 signatures on a petition and launched an appeal against the decision.

While they waited, Maureen began paying for a private treatment session which stopped the cancer growing and shrunk the tumour on her lung.

And when the decision not to help Maureen was finally overturned in February 2007 the PCT started a series of free treatments - but it was too late and by the cancer had become inoperable.

Fred said: "Who knows what would have happened if she'd started on the drug when she was first diagnosed.

"When you're told you have only a few months to live you need to devote yourself to getting better - not fighting bureaucracy.

"Anything which means patients don't have to do that any more is a good thing."

Cancer Sufferer: Steve Ort, 60
Told he had bowel cancer and just two months to live, Steve thought he was doing well to have survived after a year.

But during a chemotherapy session he discovered the man opposite him was on a drug he had been told was not "costeffective".

He said: "This man was raving about how good it was, while the drugs I was taking really knock you off your feet.

"When I've had a course of chemo it affects my quality of life and I have to take to bed. It means I never know when I will need to go the toilet so we can't go fell-walking like we used to - or even stray far from home."

A course of the drug Cetuximab costs about £6,000, but it has not been approved by NICE, which says it is too expensive.

But the man Steve met had been accepted onto a clinical trial - which had given him a new lease of life. The drugs are also available privately and Steve had a lump sum payment from his pension which he was prepared to spend on it. But he had been told if he does, the NHS will not treat him at all.

He said: "Surely if patients pay for some things themselves it will save the NHS money. As it is, there's one health service for the rich and one for the poor.

"Instead of everyone being raised up to the highest level of care, we all have to be lowered.

"Even if NICE can approve things quicker, it will still be able to decide that drugs like Cetuximab are too expensive."

Case studies by SUSIE BONIFACE