The National Health Service (NHS) healthcare postcode lottery

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NHS treatment can vary depending on which region you live in. The healthcare "postcode lottery".

Where you live can determine the NHS treatment you receive

The biggest hope when NICE was formed, was that it would mean the end of what has been known as the 'postcode lottery', namely where a patient on one side of a street may be given access to treatment denied to his neighbour on the other side, solely due to the fact that they fall under different health authorities, who have different priorities regarding treatment.

Hopes that NICE would rectify this problem were frustrated at first when it emerged that local healthcare trusts were ignoring the recommendations of the organisation and making their own independent decisions. In theory this was resolved in 2002 when the trusts were legally obliged to provide funding for those treatments recommended by NICE.

However, the problems of different treatment for different parts of the country remained with implementation being variable across local hospitals and Primary Care Trusts (PCT) with the problem being especially acute in cancer treatment.

The Government admitted in 2004 that in some parts of the country cancer patients were three times more likely to be prescribed life saving drugs than in other areas.

In the case of Herceptin, there was a 17-fold difference between its prescription rate in some areas such as Derby and Burton and that of Dorset and Southwest London.

NICE criticised the local healthcare trusts for the discrepancy with Andrew Dillon, Chief Executive of the organisation saying that if NICE had decided that a particular drug was too expensive, it was wrong for individual PCT's to agree to pay for it as that would inevitably lead to inequality between different areas.

As removing postcode discrepancies was so important to NICE coming into existence in the first place, the fact that irregular implementation can actually make the problem worse, compounding existing health inequalities, has been used as yet another stick to beat NICE with.