Yorkshire Patients Still Face Treatment Lottery
Posted on: Wednesday, 7 May 2008, 00:00 CDT
PATIENTS still face massive differences in access to NHS treatments both new and routine depending on where they live in the region, a Yorkshire Post survey has found.
In the worst affected area, nearly 3,000 patients in North Yorkshire were last year referred to expert panels which made rulings on treatment ranging from cancer drugs and heart operations to fertility therapies and plastic surgery following drastic financial restrictions.
Patients face far fewer hurdles in accessing treatments in Barnsley and Doncaster, where figures show health chiefs are much less likely to hold case-by-case reviews into high-cost or unusual treatments.
Yorkshire Post analysis suggests seven in 10 patients in Hull have their requests turned down by panels reviewing exceptional treatments, while in Leeds more than seven in 10 are accepted.
Panels also have significantly differing levels of expertise. In Leeds and Doncaster, hospital and mental health experts are called in to make relevant decisions while patient views are represented in Bradford.
The differences have remained entrenched despite years of complaints about "postcode lotteries" and a series of measures designed to iron them out.
Health chiefs in Yorkshire admit there are problems and today they are pledging to make NHS decisions on access to treatment clearer, setting out core principles officials must consider.
The latest to fall victim is a cancer patient from Scarborough who is being denied access to his last hope for drug treatment, while other sufferers at the same clinic get the drug free.
Derek Hoff, 59, was told last week that North Yorkshire and York Primary Care Trust (PCT) had refused to pay for treatment with the drug Sutent to treat secondary cancer tumours in his liver - even though patients from other parts of the region treated at the same NHS clinic in Hull receive funding.
Mr Hoff said: "For five years I have battled with cancer - now I find I'm battling with the care trust.
"How can that be right for a drug which has a proven history of working on myself and when I have no other choice? Without the drug, the tumours keep growing, the liver stops functioning and then it's basically goodbye.
"I could be sitting in the clinic next to people from Beverley, Hull or Grimsby and we could have identical problems but our consultant would not be able to prescribe this drug to myself but could to the other people he treats."
Mr Hoff's MP, Tory Robert Goodwill, has taken up his case. He said patients were being victimised for past poor financial management of the NHS in the area.
Mr Goodwill said: "This is another example of the postcode lottery that patients in North Yorkshire have to face.
"It's bad enough other patients getting drugs that you can't, but in this case it's the guy sitting next to you in the consultant's waiting room who can have the drug because of where he comes from.
"We're all paying the same into the health service - why is it my constituents can't get the same out? We don't want different treatment, we want equal treatment."
The medical secretary of North Yorkshire Local Medical Committee, Robert Givans, representing GPs, said restrictions imposed last year by NHS chiefs were a money-saving device which had proved "extremely frustrating" for both doctors and patients
"The situation has improved but it's still not good. We've won quite a lot of cases after going through the appeals process but it takes time," he said.
"The patient doesn't know where they are and the doctor is frustrated about it."
Regional health authority chiefs say decisions about access to expensive drugs and treatments will be made clearer with a new pledge setting out core principles for NHS staff to follow when they consider exceptional requests for funding.
Patients can expect that PCTs will:
consider every funding request on its individual merit;
make every decision on the best clinical and cost effectiveness evidence available;
be transparent and fair in every decision;
have a clear and timely appeals process;
ensure that the patient's clinician is fully informed throughout the process.
The chief executive of NHS Yorkshire and Humber, Margaret Edwards, said: "Tough decisions need to be made when allocating funding for drugs and treatment.
"I want all our PCTs to explain the principles on which they make decisions so that public and patients can understand the decisions that have to be made every day."
She added: "We cannot, and should not, offer every expensive drug simply because it may work."
North Yorkshire and York PCT said it could not comment on individual cases but it decided last year that based on the evidence Sutent should not be routinely prescribed, which was in line with other organisations.
It said: "The PCT has a responsibility to consider the evidence base for the clinical and cost effectiveness of a treatment for a particular patient, alongside a responsibility to prioritise our resources based on the overall health needs of the population.
"The PCT is always willing to review individual cases if a patient's consultant is able to provide additional information which may demonstrate this patient has exceptional circumstances."
(c) 2008 Yorkshire Post. Provided by ProQuest Information and Learning. All rights Reserved.
Source: Yorkshire Post
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