A new report by the government cancer Tsar, Professor Mike Richards, is highly critical of differences in the way cancer services are provided. The report found that some patients are still being denied key drugs depending on where they live, despite guidelines by the National Institute of Clinical Excellence on what treatments should be made widely available on the NHS in England and Wales.
Health Secretary John Reid ordered the inquiry last October.
Have you experienced 'postcode prescribing'? What should be done to ensure patients receive equality of access to drugs?
This debate is now closed. Read your comments below.
The following comments reflect the balance of views we have received:
Does a persons human rights not include the right to fair and equal treatment, wherever they live in the country? What gives the government the right to in some cases decide who lives or dies, or at least who has a comfortable life rather than live with avoidable pain or symptoms. As someone else said, it is supposed to be the 'NATIONAL Health Service'!.
Mark, Weston-super-Mare, UK
 |  The NHS is shamefully awful at management and organising  |
Blaming 'lack of resources' is wrong: this is not about money: the NHS is awash with cash, but it's about the way it's spent. The NHS is shamefully awful at management and organising, simple as that. The government thinks it can solve every problem by chucking taxpayers' money at it: yet they've known about this problem for 4 years and have done absolutely nothing!
John, London, UK Criticism of the drug industry is easy, but totally unfair. It costs several billion to produce a new drug. the drug companies then have only 5 years to recoup costs & make enough profit to encourage further investment. Without billions in investment there are no new drugs... and I don't see the government funding such research.
Peter, Nottingham (U.K)
When things are applied uniformly across the country, they complain about the lack of local control and overbearing bureaucracy. When things are controlled more locally, they complain of postcode lottery (as local control will invariably lead to local variation). They can't have their cake and eat it I'm afraid!
Gina, England
From a medical point of view, we all want the best for our patients, but unfortunately real life (and finances) intervene - some treatments are phenomenally expensive and just can't be justified in terms of cost per patient. Sadly that's the world we live in. Demanding patients, tired staff and incompetent management all take a toll on our weary NHS service. Solution? Sorry, cant help you there.
Nick, Leicester
| We don't pay tax on a postcode basis so we shouldn't be treated by postcode |
We don't pay tax on a postcode basis so we shouldn't be treated by postcode. It is, as has already been pointed out a national health service.
Pete, Yate, England The NHS has improved so much under the New Labour funding largesse being lavished upon it that your chances of surviving cancer are in large part dependant upon where you live! In this day and age, this is nothing short of disgusting! This affects us all, regardless of your political ideology, race, social background, whatever - lets not forget that one in three of us will get some form of cancer at some point in our lives. The only hope is that our politicians set aside their ideological differences and sort the mess out. The continual use of the NHS as a political football in election wars, given this sorry state of affairs, is nothing short of repugnant.
Rob, England
It's time the N in NHS stood for National rather than Notional.
Paul James Weighell, Purley, England
This phrase "postcode lottery" is becoming rather overused these days. Is it surprising to anyone that an organisation as huge as the NHS sometimes appears to have differing standards in different regions? Indeed, could we really expect there to be identical standards, when the regions themselves are not identical?
David Hazel, Fareham, UK
This should all fade into insignificance when the UKIP buy us all a hospital each with the money they are going to save from the EU.
Andrew M, Walsall, UK
With the levels of taxation - both direct and stealth - we are paying it is incredible that there is still a shortage of cash for the NHS. It's been many years since a Tory government - Labour must take the blame for poorly focused spending, waste through PFI hospitals and a total failure to follow their election commitments for the NHS. Safe in Tony's hands? I think not
Alun Thomas, Swansea, Wales In my work I in cancer information, I have found that services vary according to which Cancer Network people live in and which hospital they live closest to. Although ideally all cancer patients would have their case reviewed by a team of staff who specialise in their specific type of cancer, that is not always possible, especially for rare cancers.
Anon, Leeds, UK
There is unfortunately no perfect system for healthcare and its distribution. Is a postcode "lottery" better or worse than other systems - such as income barriers? There clearly has to be "some" rationing of health care somewhere, although I do not think that the availability or otherwise of chemotherapy for malignant disease should be dictated by one's address. This question should be the much wider one of just how can we ensure equality of treatment for everyone in a health care system. Perhaps some procedures currently available will have to be limited, or made available only with certain conditions attached. Much public discussion and consultation is needed.
Elisabeth, Sydney Australia The NHS should never be short of money. It's as simple as that. It is up to whoever is in power to ensure this, and if this means higher taxes, then so be it. All of the problems associated with the NHS, waiting lists, postcode lotteries, bed shortages etc, are down to lack of cash. All of these problems could be solved if we stopped wasting our money on other things (like Iraq, for instance). I would much rather our leaders were able to say "Sorry Mr Bush, we can't afford to go to war", than "Sorry Sir/Madam, we can't afford to save your life!"
Rob, London, UK
"Rob, London" doesn't seem to realise that the NHS isn't short of income, it just doesn't spend it very wisely. Instead of hiring more managers and pen-pushers they should be hiring more doctors and care staff. I don't want my taxes to go any higher to support a towering folly that is the NHS in its current form - bureaucratic, monolithic and answerable to nobody.
Nigel, England
Just shows we don't have a National Health Service since the treatment you get depends upon where you live.
John, UK
| I am forced to pay for a substandard service. |
I am looking for a way to 'opt out' of the NHS and go 100% private. However, I'd still be paying towards the NHS when I'd rather have that money towards private health care. I am forced to pay for a substandard service. Maybe the NHS needs to pull money away from doing free cosmetic work and put it into live treating life threatening illnesses such as cancer.
Tony Kenny, Barrow, UK Perhaps there should be a readily-available list of what should be available so that people can consult it if they feel they have been unjustly refused. Then an efficient procedure for challenging the refusal (i.e. not taking months or years) could redress the balance. Health authorities that lost cases could then be charged for it, thus making it cheaper to provide the drugs in the first place.
Dave, Cambridge, UK
Rather than questioning the way in which these drugs are rationed, shouldn't we be pointing the finger at pharmaceutical companies who turn massive profits every year by charging exorbitant prices for life-saving medicines?
Ewan Gardner, Dorset, UK
If decisions are made on local priorities, then we are not in a NATIONAL Health Service. If decisions are made on advice from a national organisation then we should be in a National Heath Service. The managers and other 'grey suits' might need to check on the decisions of clinicians and ensure there is no local interpretation. Keep the NHS national, I say.
Wendy B, Ipswich, UK It was shown with fertility treatment - some people objected to being reduced to only one funded treatment even though it meant giving those with no chances that one funded chance! It isn't easy to keep everyone happy and there is only so much money to be spread around in the NHS.
Tracey, Durham, UK
| The provision of cancer drugs should be made by a central authority equally to all health authorities |
It isn't just about drugs, it's about surgery and other health facilities too. I have a friend who has travelled into other areas of the country to qualify for treatments for her cancer, others do the same. It's not an ideal thing to be doing when ill, and those who are poorer do not have that chance. The provision of cancer drugs should be made by a central authority equally to all health authorities. After all, 1 in 3 of us will need treatment for this at some stage in our lives where ever we live.
Elaine, Newcastle, UK When will this government (or any other) actually get behind the people who deliver the services? With one hand they demand ever greater administration (patient consent for every possible use of every scrap of tissue) and then complain when money isn't around for things which really matter. Stop pandering to the public and giving them a choice where they neither need nor actually want it and we may just get more drugs out of the budget!
Mat, UK
We're supposed to live in a free and equal democratic country! Denying a cancer sufferer who lives in a poorer area from medical help is disgusting.
Chantelle, Manchester, UK
| Postcodes don't prescribe treatment - doctors do |
Postcodes don't prescribe treatment - doctors do. If doctors in different parts of the country are doing different thing it is because the doctors, or their local funding bodies, have different priorities. Perhaps this reflects the local accountability all the major political parties say they are trying to encourage. Presumably the "postcode lottery" is will get worse if the politicians' slogans are turned into reality.
John, Fleet, UK Certainly in my NHS region this is not the case. Indeed, considerable efforts have been made by clinicians, managers and PCT colleagues to ensure that those who have proper clinical need for cancer treatments receive exactly that treatment at a time and place of their choosing (as far as is possible). There are 3 elements which need to be considered: is the Hospital Trust failing to authorise, is the PCT failing to authorise, or is a clinician not authorising the drug spend.
In my own experience of leading a Cancer Service, there is unequivocal support to give patients full and complete access to therapies including high-cost drugs. Therefore we do not have postcode prescribing, and access is equitable. Cancer Services within the NHS is something to be proud of.
Cancer Services Manager, UK
| Healthcare based on wealth is regarded as unacceptable |
When there isn't the money to pay for drugs for everyone they end up getting rationed one way or another. One way involves making people pay for their drugs but healthcare based on wealth is regarded as unacceptable. So instead we have a largely random method of rationing. Perhaps if there were fewer administrators and managers within the NHS and if less money were spent on elective procedures for vanity reasons there would be more money to treat life-threatening conditions.
John B, UK Postcode prescribing may sometimes simply reflect local priorities. If we're responsive to local needs, won't that sometimes 'appear' to be postcode prescribing?
Graham Brack, Truro, Cornwall
The obvious way to prevent "postcode prescribing" would be to have all drugs paid for out of a UK-wide central fund. Might lead to "calendar prescribing" when the money runs out at the end of the financial year though.
Nicola Kerrison, Cambridge, UK
One-Minute World News 
News services
E-mail this to a friend 
Printable version 