Last week, this blog wrote strongly in favour of David Nicholson’s hints that it might not be too long before choice might eventually be expanded to allow patients to choose their commissioner or PCT - and not least because it could end the postcode lottery in the NHS. If ever there is a case to support this it is the figures released today by the Conservatives on cancer care expenditure. This proves it really is a lottery, just not a very funny one. Oxfordshire PCT spends £5,182; Nottingham City PCT spends £17,028 and spending by the rest is spread right across the range in between. Clinical need alone cannot account for such wild differences.
Some will say this is the ultimate case for more central direction to ensure ‘equality’, but this would be disastrous – the last seven years have well and truly proved this approach doesn’t work. Enabling patients to vote with their feet by switching PCT if not satisfied with the outcomes of their care would be a much more effective way.