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Don't take on the task of rationing, Phil

Phil Peverley's dilemma clearly demonstrates the main problem of fundholding under the last lot and PBC under this lot (Peverley, 31 May).

Phil, you are being asked to do the 'R' word – rationing.

It's not an enviable prospect, having the sword of Damocles hanging over your head. If you don't treat the girl and she ends up committing suicide, it will be you explaining yourself to the MDU.Don't have anything to do with it. If the NHS can't afford to treat a patient's illness, they can choose to go privately – or if they can't, I ask them to write to the PCT to see if they will fund treatment.

You can also suggest she goes and sees her local MP. The politicians are the ultimate rationers of care so let them come clean and deal with it, saying what the NHS can and can't be expected to afford. I suggest you refer her for treatment. You are a doctor, not a manager. If you are over budget, ask for more next year.
From Dr Simon Walsh, Newcastle-under-Lyme, Staffordshire

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