Letter: NHS rationing

Sir: The letter by a mother of a schizophrenic boy (30 November) highlights a dangerous tendency in current NHS planning. Attempts to off- load the responsibility for rationing on to the shoulders of doctors are becoming increasingly attractive to politicians. The last government managed to draw fundholding GPs into the rationing role. The present government looks set to make the same mistake through the setting up of Primary Care Groups.

While doctors may be in a good position to judge which patients have the greatest need for resources or who may benefit most, they have no control over the amount of resources available. In a democratic country, where the NHS remains one of the most treasured possession of our community, decisions regarding the provisions of services and medication should remain in the political arena, where the electorate may exercise their will.

Devolution of rationing to GPs not only creates the variable provision described by your correspondent, but it also deprives every patient of a true advocate within the health service. If a GP is having to balance the demands of several thousand patients, he cannot do his best for the individual.

Rationing of health resources is an important topic and requires a balanced and informed public debate so that the electorate may decide what they want. The press and the media have an important role to play in leading such a debate and in ensuring that successive governments to not avoid their responsibilities.

Dr NICHOLAS LEACH FRCGP

Market Harborough, Leicestershire