NCPA - National Center for Policy Analysis

Rationing Not So "NICE" In The U.K.?

January 4, 2000

Health care rationing in the United Kingdom is NICE, or not so nice, depending on one's point of view. Admitting for the first time in late December that rationing is part of the government's agenda for the National Health Service, the health secretary for England, Alan Milburn, explained that "The National Institute of Clinical Excellence [NICE] will help make the hard choices, and it will also protect patients from low value or obsolete interventions."

At a debate organized by the Institute for Public Policy Research, Milburn said: "The NHS -- just like every other health system in the world, public or private -- has never, or will never, provide all the care it might theoretically be possible to provide....So within our expanding health system there will always be choices to be made about the care to be provided."

Among the choices being made, contend some doctors and patients' advocates: the elderly in some British hospitals die because they are deprived of food and water in what amounts to involuntary euthanasia.

  • "It is very clear," says Adrian Treloar, a physician specializing in geriatrics, "that the elderly do not always get all of the care that they need...." and that involuntary euthanasia is occurring in government-funded NHS hospitals because of pressure for beds.
  • SOS NHS Patients in Danger, a pressure group of concerned family members, is planning to take the cases of 50 elderly patients who died to the European Court of Human Rights.
  • Age Concern England, a leading advocacy group, says the NHS discriminates against old people at all levels of the health service from primary care to major teaching hospitals.

Milburn says NICE's rulings will lead to important cost savings and will improve patient care by avoiding costly and ineffective treatments.

Source: Gavin Yamey, "Health secretary admits that NHS rationing is government policy," British Medical Journal, January 1, 2000; Reuters, "British hospitals deprive elderly, doctors say," December 6, 1999.


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