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Protestors have their say on financial management in the NHS - Health Policy Today, 28th August 2008

Amid reports of a surprise surplus for the NHS, many patients will be asking whether the money can be put toward new treatments, particular those patient protestors who locked themselves in to the NICE offices yesterday to complain about the rejection of drugs for advanced stage kidney cancer.


Today’s Financial Times reports that ‘a political row’ has broken out of health funding ‘as the National Health Service forecast a £1.75bn surplus for the current financial year.’  Amid reports that the NHS is strapped for cash and so cannot afford to pay for drugs, the news will surprise many people.  

‘The results mark a significant turnround for the health service in the two years since it recorded a £547m deficit. Only five trusts were in operating deficit for the first quarter of this year, compared with 82 in 2006-07, officials said.’

The Department of Health say the cash will be reinvested in the service.  Patients will be asking if it can go towards new treatments.  Showing he is a man who can spot an opportunity, the busy Andrew Lansley said, “the government should explain why money voted in by parliament for healthcare is not being used to make sure patients get the medical treatments that they need.”


The Daily Telegraph today makes the
connection between the surplus and protests over the availability of drugs.

“But the figures come at a time of controversy over a series of decisions by the Government's drugs watchdog, the National Institute for health and Clinical Excellence, to deny a range of treatments available in many other European countries from patients on cost grounds. Patients protested outside the NICE headquarters for access to kidney cancer drugs which - although they extend life by a matter of months - have not been judged a cost effective use of NHS money.”

‘Some of the patients protesting yesterday argued that the Nice assessment of the drugs bore little relation to their own experiences’. Jane Thompson, from West Heath in Birmingham told the Guardian that her own Sutent course - agreed by her local NHS trust before the Nice decision - had improved her health so much she had just been on a sailing and canoeing holiday. She said: "Six months ago I was facing certain death, very soon. Physically, now, I'm able to do everything that I was doing before."
According to  The Independent  the protestors held banners saying, “we deserve to live”.


After yesterday’s “U-turn” decision to fund Lucentis for an age related eye-disease (patients were previously only eligible once they’d lost sight in one eye!), Andrew Dillon told the Today programme that he was genuinely sorry NICE had taken so long to get to this point.  He said there were lessons to be learned.

The protestors who occupied his office had also talked to Dillon, but were not satisfied with the answers they received.

The Guardian  reports, ‘Clive Stone, from Witney in Oxfordshire, who organised the protest, said he felt "angry and abandoned" after meeting Dillon. "My personal message to him was that I'm dying and he's taking any hope away from me. I'm appalled," said Stone.’


Eric Lowe, who is the chief executive of Myeloma UK writes in the Guardian today that  the NHS should assess whether it is spending its existing resources effectively .

‘The NHS is accountable to the taxpayer and clearly needs to make careful decisions about healthcare expenditure. However, there must be further capacity in the modern NHS for new and improved technologies. The underlying issue is whether the NHS is spending its existing resources efficiently. An appropriate programme of disinvestment would ideally release more money to ensure appropriate health investment in new treatments.’

‘The profit margins of the pharmaceutical industry must also ultimately take a hit. With the advent of novel, targeted therapies, drug companies must move toward value-based pricing, where the price of the drug is set against its real benefit to patients. In addition, however, government and industry must find other ways to effectively reduce the price of drugs. The recent deal struck by Nice and Novartis on the eyesight drug Lucentis is a positive short-term resolution to current acute problems.”

‘Looking towards longer-term solutions, there should be an onus on the pharmaceutical industry to generate better data on their products, so as to reduce uncertainty about their effectiveness and appease the Nice system. Nice must also commit to generating longer-term solutions by rethinking the rigidity of the QALY, in order that expensive drugs for certain types of conditions do not fall foul of its parameters.’


The row over the availability of drugs, and the Panorama documentary on the postcode lottery, is helping the public understand more about the role of PCTs locally.
It is in the interests of PCTs that the public better understand what they do so it is positive news from the Plymouth Herald which today reports that   the local PCT will hence forth be known as NHS Plymouth.

In the funniest story of the day (my day, at least), the paper reports a poll which asked local residents what they thought the PCT was.  Most popular answer?  ‘Many members of the public though PCTs were responsible for emptying bins’.