Stephen Thornton, chief executive of the NHS Confederation, said health migration, in which patients moved around the country in search of the drugs they needed, was a reality and to deny it was "unhelpful". Aids patients had gathered 10 years ago in north-west London, where the services were best. It was a natural response to an unsatisfactory situation.
"What the pressure groups should be doing is producing a directory of where you go if you want better services."
Mr Thornton's remarks are quoted in a report, Hard Rations, published yesterday by the Association of the British Pharmaceutical Industry (ABPI), which describes a "patchwork of medical fiefdoms across the country", each with its own rules about what drugs should be provided, but where the basis of the judgements is shrouded in secrecy.
Some health authorities are less generous than others in their provision of drugs. Northamptonshire will not pay for Taxol for first-line treatment of ovarian cancer and West Hertfordshire declines to fund cholesterol- lowering drugs except to patients who have already survived a heart attack.
A survey of 200 GPs conducted by NOP found almost six out of 10 said their patients did not always get the best available treatment, regardless of cost. Of these, over half said their local health authority had said it could not afford the treatment or had issued guidelines not to provide it.
Dr Trevor Jones, director-general of the ABPI, said: "The Government has steadfastly denied there is a need for rationing, but this survey shows that doctors are not prescribing the best treatment for patients - primarily on cost grounds. That is only rationing under another name."
The Department of Health said yesterday that the National Institute for Clinical Excellence, which starts work in April, would appraise new treatments, new drugs and new medical devices and issue "authoritative" guidance.Reuse content