The postcode lottery

The term 'postcode lottery' became popular in Britain in the late 1990's to refer to the variations in health care from one area or region to another. It suggested that variations or inequalities in health care provision or drug availability or treatment were essentially random and varied depending on where you lived. Subsequently the term has been widened to refer to variations in educational provision, job opportunities, welfare availability and many other things. But in some respects the term is a misnomer. There are variations from one area and one region to another but they are often geographically structured rather than just random. And there are big variations in access to financial services and to even retailing. In 1971 the geographer David Smith raised the question of 'who gets what, where and why?'And Julian Tudor Hart, a radical GP, put forward the idea of the 'inverse care law' where access to medical services often varied inversely with need. The poorest areas with greater need often had lower levels of provision and vice versa. Its an important geographical issue.