Thursday, 6 August 2009

Postcode Lottery -v- Local Decision Making

What is the difference between a "postcode lottery" and the devolution of local decisions to local bodies?

I only ask, because, according to the BBC, there is a "postcode lottery" for fertility treatment: i.e. if you live in different areas, such treatment might be given a higher or lower priority in terms of spending, delivery etc.

But then, we are all aware of the outcry that occurs when central government intervenes to direct spending and resources (NHS or otherwise) in a particular direction. Up goes the cry of "too much central interference" and "why can't they leave local decisions to local people?". So when does a "devolved decision" become a "postcode lottery"?

It always annoys me when the BBC, in particular, follows the tabloid view and takes the lazy journalistic path of sloganising rather than thinking the situation through. In an interview on Breakfast TV, an NHS representative pointed out that there is no centrally enforced rule. There are "guidelines" which can be interpreted and applied on the judgement reached by local agencies and taking into consideration local conditions and priorities.

This is the perfect definition of a locally devolved decision making process.

Think of the complaints if central government applied rigourous rules and strict regulations on the provision of this type of treatment. The first case which fell outwith the rules, or offered some ambiguity or difference from local practice or failed a local test of some sort, you would hear the voices of complaint all over the airwaves. Probably the same people who complain about the so-called "postcode lottery".

Come to think of it, far years now we have been spending more per head of population in Scotland than on England, on the NHS. Is that "devolution" or the ultimate "postcode lottery"?

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