Examples of postcode prescribing litter healthcare across North Staffordshire. Dave Blackhurst looks at why some patients are winners, while others are losers.

FIVE years ago, a single health authority was running the NHS across the whole of north Staffordshire. It meant the care was the same whether you lived in Burslem or Bagnall; the West End or the Westlands.

But all that disappeared when the then North Staffordshire Health Authority was swallowed up by four primary care trusts (PCTs).

At its most bizarre, a health bus packed with advice for patients could only travel around the north of the city because it was solely funded by the then North Stoke Primary Care Trust.

Now healthcare in North Staffordshire is run by two bodies – NHS Stoke-on-Trent and NHS North Staffordshire.

But examples of postcode prescribing between the trusts keep on coming.

The latest one concerning speech and language therapy sees children within NHS North Staffordshire getting help within five weeks of referral, while city youngsters have to wait 13 weeks.

It means the well-heeled Westlands get better access to the therapy than deprived city communities such as Bentilee, Chell Health and Meir.

NHS North Staffordshire chairman George Wiskin, pictured, whose board jumped at the chance to pump more money into speech and language therapy, said: "We accorded this a high priority because we knew the problems it would address are often related to areas of higher deprivation and so here was a chance to narrow health inequalities.

"Conversely, we have come in for some criticism – not least from Newcastle MP Paul Farrelly – for giving a lower priority than other PCTs to fertility treatment.

"Nevertheless, I strongly believe in giving individual PCTs the freedom to set their own priorities to address what they see as the most pressing needs confronting their population.

"That allows local people to have an influence on decisions taken in their name by their health leaders. In turn, those leaders have to be accountable to the people they serve.

"If every single target was centrally laid down for every PCT, you would lose some of that accountability."

The Government does set down a number of targets, including how long people wait at accident units, the time it takes to get an operation or see a specialist if cancer is suspected and the number of healthcare-acquired infections breaking out in each hospital.

But beyond that, the health trusts enjoy more freedoms than the previous health authorities to set their own priorities and introduce local targets.

Within the two local trusts, there are different service levels in speech and language therapy, stomach reduction surgery, dental health promotion, night and weekend opening times at GP surgeries, incontinence treatment, access to physiotherapy and child and adolescent psychiatry.

While some parts of Newcastle and the Moorlands have much in common with parts of the city, Ian Syme, leader of campaign group Healthwatch, believes there is a big enough difference in the overall deprivation levels to allow PCTs to set some of their own priorities tailored to their own populations.

But he added: "I feel children's services are so poor nationwide that they should be covered by common must-do targets for all PCTs. NHS North Staffordshire deserves credit for giving these services a high priority and involving the public in setting local priorities.

"Admittedly, Stoke-on-Trent PCT had bigger debts two years ago to tackle but it must now start to move more quickly to find what services the public feel should be top of their list.

"It is horrifying for 200 kids in Stoke-on-Trent to be delayed so much longer for speech and language therapy for disorders which are having a traumatic impact on their lives. I would invite NHS Stoke-on-Trent to book a hall, invite all the parents along and explain why this happens.

"It must also be demoralising for the therapists to have to hold off treatment for kids from one area when they know there is only a small window where they can intervene with maximum effect. These caring professionals have a duty of care which is being frustrated."