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Should Phil treat red nose...

I write in response to Phil Peverley's red nose dilemma over whether the NHS should fund treatment for acne rosacea (Peverley, 31 May).

The UK is the fifth largest economy in the world. We pay huge amounts of VAT and other taxes. We have the best and most cost-effective health service in the world. If care is to be rationed, let politicians decide, explain and justify their choices and apply them across the board, to me, you, themselves and our families.

It's not your job to apply arbitrary, local, poorly thought-out rules, devised by politicians who would all have been struck off for gross incompetence by now if only there was a GMC-style register for politicians.

A patient has consulted you on a condition that affects her ability to earn a living. If resignation or readjustment is the best option for her, do your best to explain that to her. If the benefits of a procedure would outweigh the risks, sign off the surgery without a second thought.If I would expect to have a procedure on the NHS, I expect it for all patients, and I would not allow them to be fobbed off. That's how I sleep at night.
From Dr Raymond Sullivan, Tipton, West Midlands

... or dismiss as a waste of resources?

My advice to Phil is to stand firm over the rosacea laser treatment (Peverley, 31 May).

It is a low priority for use of resources. Our PCT (previously Newcastle under Lyme, now amalgamated into North Staffordshire PCT), of which for my sins I am a PEC member, took the decision a couple of years ago that we would no longer fund low-priority treatments.

Cosmetic surgery was very definitely in this group. As such in our area, cosmetic surgery referrals would not be made anyway.

The GMC also has a view in Good Medical Practice that one of the duties of the 'good' doctor is to maximise the use of limited resources for the greatest good of the population. A couple of hips versus a red nose comes down in my view on the side of the hips!
Dr Richard Page, Audley, Staffordshire

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