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London NHS care is postcode lottery
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08 September 2008
Research by The Kings Fund shows wide variations in health trusts' spending priorities for cancer, heart disease, life-threatening injuries and mental health.
Some London primary care trusts spend the lowest amount per patient in the country.
A league table shows Ealing comes bottom in England for cancer spending at £47 per patient. This compares with the highest spender, Redbridge, which allocates about £89 per patient.
The trust also allocates more per patient than any other London trust for heart disease - £132 per head.
Bottom of the league are Haringey and Southwark which allocates just £76 for cardiac treatment.
Barnet Primary Care Trust tops the league for injury and trauma care with a spend of £81 per patient - nearly five times as much as Lewisham which comes bottom in London.
Islington spends £332 per head of population on mental health - the highest anywhere in the country. Health campaignerswarned that patients are being condemned to a "death sentence" by trusts that spend the least on care.
Geoff Martin from pressure group Health Emergency said: 'We've been promised so many times that this postcode lottery would end. But these figures show huge gaps between quality of care. What it means is that people are being condemned to death because of spending."
The five capital primary care trusts which spend the least per cancer patient are Ealing, Westminster, Kingston, Kensington and Chelsea and Southwark. The five highest spending are Redbridge, Sutton and Merton, Hounslow, Havering and Bromley.
Liberal Democrat health spokesman Norman Lamb said: "This report begs urgent questions as to what extent these extraordinary variations in spending are affecting patient care and leading to higher death rates."
The findings are based on spending information per head of the population submitted to government by primary care trusts over the past three years. Researchers at The Kings Fund took into account factors including age of patients and poverty levels between primary care trusts.
But the figures still reveal wide spending variations. Across the country the highest spending trusts invest two and a half times more on cancer than the lowest spending. The top trusts spend 2.2 times more on circulatory diseases.
Professor John Appleby who carried out the research said some of the differences were not solely down to deliberate choices by health bosses. But he said the findings raised questions about the consistency of decisions about spending on different diseases.
The economist said: "We have a long way to go - tackling unjustified variations in spending will first require much more effort in understanding why variations occur, and persist. And second, making determined efforts to change spending patterns to produce a more efficient and fairer NHS."
London PCT spend on cancer treatment per head of population
Barking and Dagenham £72
Barnet £78
Bexley £77
Brent Teaching £58
Bromley £79
Camden £61
Croydon £75
Ealing £47
Enfield £69
Greenwich Teaching £68
Hammersmith and Fulham £65
Haringey £69
Harrow £53
Havering £80
Hillingdon £59
Hounslow £84
Islington £64
Kensington and Chelsea £50
Kingston £50
Lambeth £62
Lewisham £64
Redbridge £89
Richmond and Twickenham £71
Southwark £51
Sutton and Merton £87
Tower Hamlets £65
Wandsworth £56
Westminster £48
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