BMJ  2005;331:1472 (17 December), doi:10.1136/bmj.331.7530.1472

Letter

Rationing in response to NHS deficits: rural patients are likely to be affected most

The first 150 words of the full text of this article appear below.

EDITOR—News that pressing financial problems have caused NHS trusts in Suffolk to set new "thresholds" to treatments such as joint replacements reinforces concerns raised by a recent BMA survey of medical directors of trusts in which over a third of respondents anticipated reductions of key services in response to funding shortfalls.^{1 2} What has hitherto escaped comment is how cuts in services are far more likely to be felt in some parts of the country than others.

Deficits in the NHS are invariably presented as a problem of financial mismanagement, but the pattern of deficits shows that the current resource allocation model discriminates against particular communities. According to the recently published accounts for 2004-5,³ 89 out of 303 (30%) English primary care trusts ended the year in deficit. The table shows how 301 of these trusts are distributed accorded to fifths of deprivation and rurality.

View this table: [in this window] [in a new window]   Distribution of primary care . . . [Full text of this article]

 

¹ School of Sociology, Politics and Law, University of Plymouth, Plymouth PL4 8AA sasthana@plymouth.ac.uk, ² Faculty of Health and Social Work, University of Plymouth

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