The postcode lottery in health care lives on

The postcode lottery was something that the National Institute for Health and Care Excellence, as it is now called, was originally set up to eradicate back in 1999.

By examining the clinical and cost effectiveness of treatments the aim – a worthy one – was that NICE would examine the evidence, make a decision and commissioners would follow its lead.

Of course it was never going to be easy. There have been many controversies but, sadly, one constant – inadequate funding for children’s services. 

Funding reduction

In this month’s issue Nick Evans looks at public health and how local authorities up and down England – faced with a reduction in their funding from central government  – are making budget cuts.

These are harsh decisions that have a direct impact on children’s health. School nursing, family nurse partnerships and health visiting services are all threatened.

Also the charity WellChild, which celebrates its tenth anniversary this year and funds vital work with children with complex needs and their families, is calling for a review of the workforce and training.

National guidance

Manchester children’s nurse Tracy Brooks describes how there is no clear national guidance on what help families should get when their child leaves hospital. 

Good care packages are available in one area, yet down the road another child with similar needs is getting less support. This leaves families with a ‘fight on their hands’ to convince community services of their child’s needs.

Complex needs

The charity took the lead with the RCN in 2009 warning of community children’s nurse shortages and the growing need for their services to enable children with complex needs to be cared for adequately outside hospital.

Seven years later the numbers of CCNs needed to help them have not increased to what is really needed. Some families are caring for their child round the clock and may not even see a CCN.

The postcode lottery is, it appears, alive and well.