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GPs are the convenient scapegoat for postcode lotteries

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The reports that IVF is being rationed by various CCGs is of no surprise to anyone – it has been happening for years now. I stand to be corrected, but in my mind, IVF is the most blatant form of rationing by CCGs.

An otherwise healthy 30-year-old patient might be entitled to it – their equally healthy 30-year-old near-neighbour down the road will not be. There is no dressing this situation as ‘clinically inappropriate’ (as they might do for imposing thresholds on hip replacements, for example) – the only justification for rationing is on cost.

I understand there will be people who argue that IVF isn’t core, and the NHS cannot afford to provide ‘nice-to-have’ services (although there are equally strong arguments about the detrimental effects it has on the mental health of those affected).

But this is an issue of fairness, and there is no justification for postcode lotteries. Patients are offered treatment depending on their CCG, which is unconnected to local tax rates – and they don’t have the option of voting a CCG board out.

The 2012 reforms shifted the blame for unpopular decisions onto GPs

Postcode lotteries have been around for ages. But what the 2012 reforms did was shifted the blame for unpopular decisions. And NHS England’s statement in response to the reports yesterday made clear this is still the attitude: ‘Ultimately these are decisions for local GPs, who rightly decide how best to balance the various competing demands on the NHS.’

Thank you, Andrew Lansley.

Jaimie Kaffash is editor of Pulse.You can follow him on Twittter @jkaffash or email him at