'End postcode lottery health care'

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Andrew Dillon, chief executive of the National Institute for Health and Clinical Excellence (Nice), said Primary Care Trusts (PCTs) should be consistent when deciding whether to make funds available for medicines.

His comments follow growing public anger over the number of drugs and treatments being blocked by Nice.

Mr Dillon told the BBC's Panorama: "It shouldn't make any difference where you live. There ought to be a common basis for making decisions about exceptional circumstances and I think anybody who uses the NHS for their care is entitled to expect that.

"What patients need to do is to find out from those who are making the decision what the basis of that decision is, and if they don't think it's reasonable, if they don't think it compares appropriately with decisions that are taken elsewhere, ask 'why not?'"

NHS trusts have a legal obligation to provide treatments approved by Nice. But, in the absence of such approval, a patient must appeal to a committee at the local trust which can choose to fund it as an exceptional case.

Those who are refused must settle for a less effective treatment or pay privately for the drugs - at the risk of having all other NHS care withdrawn.

Cancer consultant Mark Saunders, from Manchester, claimed there were huge inconsistencies. He launched an investigation after cancer sufferer, Naomi Kiely, 34, claimed she was unable to get potentially life-saving drugs because her PCT would not approve it.

Mr Saunders said: "If you have a patient from Cheshire they have a very good record. Most of the time we apply to Cheshire they tend to fund patients that have exceptional circumstances. If we apply to the Manchester Primary Care Trust then in the eight applications we've made they've only accepted one for funding in 2006."

During the Panorama programme Mr Dillon also hints that Nice may not be able to meet the Health Secretary Alan Johnson's recent pledge to try to bring decision-making on new drugs down from an average length of two years to just three months.