Mark, Rod, All,
I have always found this debate about rationing/prioritising
interesting but also repetitive as clearly this the same debate which has
been going on for at least the 15 years I have been in public health and I
am not vain enough to believe it only began on my arrival. The important
issue is openness in the process. There may be an absolute level of need for
health care but what is clear is that the level of access to health care is
defined by your(or your society's) willingness to pay. I never understood
why it was wrong for Bury to have different criteria to access IVF or hernia
surgery from Sale if those decisions were made openly and rationally and to
me that includes political decision making as well.
This is clearly important at both the macro and micro level.
Dr Kevin Kelleher
Stiurthoir Slainte Poibli (DPH)
Mid-Western Health Board
31 Catherine Street
Limerick
IRELAND
TEL: +353-61-483338
Fax: +353-61-483211
mailto:[log in to unmask]
> ----------
> From: Mark Newman[SMTP:[log in to unmask]]
> Reply To: Mark Newman
> Sent: 10 March 1999 13:02
> To: [log in to unmask]
> Cc: [log in to unmask]
> Subject: NNT/ risk/ resources
>
> Rod
>
> Coming off the NNT debate slightly I was interested in your comments
> about the need to consider the 'best' use of scarce
> healthcare resources. In U.K this issue is part of wider discussion
> of 'prioritizing' or 'rationing' (depending on your
> politicial/ideological perspective) of healthcare and one which I
> think will again be raised once the full impact of Primary Care
> Group commissioning starts to become operational. In U.K many of
> these kind of decisions have been devolved to health authorities
> and/or individual clinicians. Partly as a result of this we have the
> well reported variations in access for services such as I.V.F for
> example. It seems to me by linking the issue to questions of
> resources it becomes much more than just a clinical one What I
> am interested in is how and by whom the figure of 10-15% 5 yr risk of
> CVD was decided upon did for example the public have any involvement
> and if so how was this achieved.
>
>
> mark
>
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