Personal Injury, Serious Injury & Clinical Negligence

NHS Reforms and the Post Code Lottery

The Health And Social Care Act 2012 – the most significant NHS reform since 1948

Under the present system the Secretary of State for Health is under a Statutory duty to provide health services, and for the most part this responsibility is delegated to the regional 152 Primary Care Trusts (PCTs) throughout England. In practice this means at present local PCTs make most of the decisions as to how health services and resources are to be allocated in any particular area in line with their own budget.

There has always been a concern that within the NHS there exists a “post-code lottery” whereby particularly expensive treatments or services are only available within the local catchment area of some PCTs and not others. In the event of a PCT making an unreasonable or irrational decision in relation to the provision of a particular drug, service or treatment it has been possible to challenge the decision in the Courts through a process known as Judicial Review.

Under the Health and Social Care Act 2012 the 152 PCTs in England are to be abolished by 2013 and they are to be replaced effectively by new organisations called Clinical Commissioning Groups (consisting of GPs and other health professionals) which will make decisions as to how health services in any particular area are to be provided and allocated.

It is not known how many Clinical Commissioning Groups there will be under the new system. However, it seems likely that there will be significantly more Clinical Commissioning Groups than the current 152 PCTs, which has led some to conclude that there is a real risk of an increase in the perceived “post-code lottery”.

Clinical Commissioning Groups and the Post Code Lottery

Any Judicial Review challenges made in respect of local decisions made regarding the provision of health services under the new system are likely to be made against the newly established Clinical Commissioning Groups, which will have more freedom from the Secretary of State for Health than PCTs do at present.

Whereas it is hoped that the reforms will enable Clinical Commissioning Groups to tailor health services to the needs of their local communities there is at the same time a significant risk that the new system will lead to an increase in health inequalities on a regional basis and a possible increase in the number of decisions being challenged in the Courts by way of Judicial Review.

Clarke Willmott is now able to offer publicly funded (Legal Aid) advice and representation on public law issues, including Judicial Review challenges made in respect of the provision of healthcare and community care issues.

We can assess whether or not you are eligible for Legal Aid so that we can assist you in understanding and securing your rights. If you are not eligible for Legal Aid, then we still may be able to help you.

For further queries contact John Boyle