The aims of the NHS
guidelines, but, as NICE simply gives guidance to the NHS, it has no legal power to make CCGs adhere to them. Some may argue that there are other, more cost-effective methods than IVF (such as adoption) and due to infertility not being an ‘illness’, it does not come under Aim II of the NHS.
The role of government in setting up NICE has been a positive step forward for the NHS and NICE has undertaken various initiatives and judgements to its best ability, but the role of government in creating CCGs has hindered their ability in implementing reform. Unwillingness by CCGs have let NICE down, especially in treatment such as IVF. Therefore, according to NICE’s aim for equity for everyone, the role of the government should be questioned here. The government is shown to have applied pressure on them in 2012. 50 but self-evidently, this seems not to have worked. In order to follow Aim II of the NHS and make sure NICE guidelines are followed, the government must make NICEs judgements legally binding to all CCGs, unless there is a strong reason not to adhere to the guidelines, if they want to abolish the ‘postcode lottery’. Otherwise, the exact purpose and role of NICE sh ould be examined.
Aim III. Services shall be free of charge
As an advertisement from May 1948 states, there will be ‘no fees to pay’ to use the NHS. Over 70 years later, the story has changed significantly . In 1951, charges for eye and dental care were introduced and, in the next year, prescription charges. However, once Labour took power in 1964, prescription charges were abolished, but in 1968 reintroduced. 51 The NHS’ primary aim that ‘services shall be free’ has not been adhered to and not being able to meet this requirement has been a government failure. However, it can be said that the NHS may not have been prepared from its foundation for the rising and ageing population and the challenges of the treatment of complex diseases. Prescription Charges Of the countries in the UK, England is the only one to have prescription charges. Again, this is a policy which is very controversial. Some argue that to create equality amongst everyone, prescription charges must be abolished. 52 However, others may claim that with an ageing and rising population, 53 it is inevitable that a greater amount of drugs will be needed and it will be hard to fund this. They make it clear that themajority (90%) of British people do not pay for prescriptions, including those with specific chronic illnesses. 54 A key problem, prevalent in the whole of the UK, is claiming for unnecessary items on the NHS. These include paracetamol, dandruff shampoos and toothpaste. These items are available without a prescription in the UK. Even if one pays for their prescription to obtain these, the administration and consulting fees can make the cost to the NHS excessive, £34 for 32 paracetamol tablets. 55 In Scotland, paracetamol was the 4 th most prescribed medicine. 56
50 PM Live, 2012. 51 Welch, 2018.
52 Hospital Pharmacy Europe, 2009. 53 Office for National Statistics, 2019. 54 Timmins, 2019. 55 Welch, 2018. 56 BBC, 2018.
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