The post code lottery, again.

Since health is rationed other than by price, and financed out of taxes, it is likely that there will always be shortages and a need to establish priorities.

Sometimes the health good is rationed over time - you have to wait a period before your need is met, perhaps an operation.

If the need is immediate, then usually resources are found - A & E, for example, although charges are beginning even here, or intensive care - unless no beds are available.

The current issue concerns IVF. The postcode lottery according to Grant Shapps, shadow minister, has worsened over the last two years. Perhaps this is because it is not usually an immediate need.

He tells us that 80% of PCTs are failing to observe the NICE (-National Institute for Clinical Excellence) ruling guidelines which require that three full cycles of IVF treatment should be provided for any couple. Two of the Primary Care Trusts admit to not having provided any IVF treatment in the past two years. Half refuse treatment for couples with existing children, even if the marriage is a second one and only one of the partners has children.

One in eight PCTs fails to comply with NICE rulings on age of mother. A woman could bizarrely find herself too young in one area and too old in another.

The government in Tony Blair promised the three cycles of treatment, but it did not provide the means. As a relatively non-urgent procedure and with many other pressing claims, it is understandable that PCTs in many cases give it a low priority.

There does seem to be injustice here, depending on area of residence. Perhaps one solution would be to rescind the promise of three treatments completely and offer subsidised treatment or low interest loans. We are talking about £5,000 per treatment, so even three such would not cost much more than a family car.

IVF, like cosmetic surgery, is non-urgent and not threatening to health or life. The latter is not permitted free on the NHS. Perhaps the latter should be also.