Deciding whether to fund treatments that do good one by one tends to lead to a positive decision. However, this can cause wider harmful effects, as West Midlands' experience in the funding of enzyme replacement therapy for lysosomal storage diseases shows
This paper describes a review of a new system introduced in October 1989 for rehousing on medical grounds, in which housing staff were primarily responsible for making both the assessment and the decision. Part of this review included a study to compare points awarded by housing staff with those awarded by a consultant in public health. Major discrepancies were found in 11.6 per cent of decisions, of which only half were considered potentially to disadvantage applicants. On the basis of this review, it was felt that there was justification in using non-medical personnel to make decisions on medical priority, with medical officers acting in an advisory capacity only. The mechanism for processing applications, however, needs careful consideration, as does the overall role of medical priority in the allocation of housing.
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