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London NHS care is postcode lottery
Sophie Goodchild8 Sep 2008
Patients in London face a postcode lottery on how much health bosses spend on urgent care, a report reveals today.
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
Barnet £78
Bexley £77
Brent Teaching £58
Bromley £79
Camden £61
Croydon £75
Ealing £47
Enfield £69
Greenwich Teaching £68
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
Reader views (4)
How about we accept the simple truth that there is only so much money to be spent. Either we narrow the services provided by the NHS or we accept huge tax increases. Everybody thinks their disease or problem is the most important, but there has to be a limit somewhere.
- Mark, London, 08/09/2008 15:00
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Seeing as Trusts are paying different amounts, does this mean that I can pay less National Insurance depending on where I live. I thought National Insurance meant National, dowsn't seem that way! When is the government going to take the reins of power away from these trusts.
- Triffid Queen, Desk in London, 08/09/2008 13:43
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If you don't want a "postcode lottery", the alternative is for Whitehall to dictate exactly how spending budgets are to be allocated, rather than these decisions being made locally. You can't have local autonomy and uniformity.
- Tonyb, Twickenham, 08/09/2008 13:01
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This is not surprising and adds weight and explains why an increasing number of patients are being taken off GP's lists because they become too costly.
- Anonymous, London, UK, 08/09/2008 12:01
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