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Lawyers warn health bill amendments may do little to prevent postcode rationing

Exclusive: Government amendments to the health bill will not prevent large disparities in the provision of care emerging across the country, say legal experts.

The 137 amendments announced by health secretary Andrew Lansley last week included a clearer directive to both clinical commissioning groups (CCGs) and the health secretary to promote a ‘comprehensive health service'.

They were designed to counter criticism that the health bill would lead to postcode lotteries in the NHS, with national newspapers briefed that they would prevent controversial schemes denying treatment to patients because of their lifestyles.

But lawyers told Pulse the bill amendments would not prevent decisions, such as that taken by Herts Valley and East and North Herts CCGs, to withhold surgery from smokers and obese patients unless they agree to undertake weight loss or smoking cessation classes.

Ben Troke, a partner at Browne Jacobson said the amendments ‘might not make very much difference to CCGs on the ground'.

‘The promise of a "comprehensive health service has always been impossible to fulfil. What has been happening in Hertfordshire is exactly what the white paper envisaged – local decision making on the allocation of resources.'

He added: ‘It will be so easy for patients to throw mud in the water and cry ‘conflict of interest', so it will be vital CCGs refusing treatments can show their decision-making processes are sound.'

Ross Clarke, a partner and head of the corporate team at Hempson's solicitors, said: ‘The amendments are actually very clever in that they appear to address concerns but actually little is changed.'

Dr Mike Ingram, chair of the single-practice Red House Consortium and a member of Hertfordshire LMC, said: ‘Treating the individual is the art of general practice. It's the key to delivering the right level of care.'

‘If we´re going to do that, we need to avoid blanket restrictions and leave to up to individual GPs to make the decisions."