EU Patients' Rights And The Health Care "Lottery"

Individual UK doctors and health authorities should not make medical decisions alone, says the Institute for Public Policy Research, a UK-based think tank. At a symposium late last year, IPPR researcher Jo Lenaghan proposed that a National health Commission should be set up to provide clear guidelines for such decisions, so the burden is shared and a code of practice can be developed. Doctors, nurses, medical experts and the public should all be involved, she said.

IPPR deputy director Anna Coote told the meeting that UK health care is becoming "a geographical lottery," with National Health Service treatment available in one area but not necessarily in another. "What you get can depend on where you live, rather than what you need," she said, and such decisions are taken every day by "unelected, unaccountable health authorities. The weight of these decisions places an unfair burden on the professions at local level."

Ms Lenaghan said a tightly-defined "basic package" of patient rights would in fact reduce such rights, lead to a two-tier system, shift costs from the state to the individual and entrench inequities. The National Health Commission would create a national framework of entitlement to guide clinicians and managers. Legal assumptions might be created, so that a breach of the code would give rise to a prima facie case of unlawfulness. It would also allow local authorities to become the purchasers of health care without fear of breaking up the NHS. She suggested an increased role for the European Union in evaluating new technologies, in order to pool knowledge to make rational choices about resources for health.