Health 'rationing' - should patients decide?

Medical science can now treat more diseases than ever before, but NHS resources are finite. Who decides which patients get priority when that resource 'cake' is shared out?
Priority setting will be one of the key controversies to be debated at this year's Annual GP Forum at the Royal Society of Medicine. The Forum (18-22 September) will discuss several unique experiments from the UK and the US and debate how they might be applied to a nationwide health system.
Among the speakers:

How legal is postcode prescribing?
Dr Geoff Payne, GP, London
"Issues, controversies and legal implications"
A health authority which decides to stop doing, say, sex change operations, would actually be breaking current UK law. Dr Payne's will look at the legal issues and human rights controversies of health rationing in an overview of priority setting here and abroad.

Patient juries: a real alternative to waiting lists?
Dr Andrew Rouse, University of Birmingham
"Prioritisation: Let the People Choose"
We have to be realistic about available health resources, argues Dr Rouse, and someone has to decide which patients will be excluded from treatment. In his opinion, it is "unelegant and dishonest" to leave it to a waiting list system, or to unaccountable decisions of individual doctors. Dr Rouse will be discussing a radical new alternative to waiting lists, based on his experience in the UK and the US. His approach would involve lay people acting as a jury to prioritise treatment, after hearing 'evidence' from fellow patients or their GP advocates.

The Oxford Experiment
Dr Sian Griffiths, Oxon Health Authority
"The Work of the Oxford Priorities Forum"
Whoever makes budget decisions, the problem of limited resources will not go away, Dr Griffiths points out. She will report on the Oxford Priorities Forum, which for the last five years has succeeded in bringing together GPs, Trusts, Community Health Councils and patients to make those difficult decisions in an open and accountable way.

Regional variations "worse than ever before" for fertility treatment
Mr Adam Balen, General Infirmary, Leeds
"Assisted Conception"
Despite government promises, the healthcare 'postcode lottery' is very real for couples seeking NHS fertility treatment, claims Mr Balen. He will argue that modern infertility therapies are "relatively inexpensive", and will update GPs on the latest advances in the management of infertility.

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