Don’t ‘economise’ on cancer drugs
THERE IS a myth t hat the NHS o v e r s p e n d s and is therefore inefficient. This claim is deliberately propagated. The fact is that the NHS is a high-quality operation, led by caring staff, which sees a million patients every 36 hours. The Commonwealth Fund, a renowned US economic think tank, recently ranked the NHS best of 11 advanced healthcare systems in terms of value for money. Compared to the US health system (11th out of 11) the NHS, for 50 per cent less funding per head, provides better care in almost every category under analysis.
The NHS is a victim of the failure to prepare properly in the past 30 years for the needs of a population which has increased by 30 per cent. There have been two main strategies to avoid confronting the basic issue of “how do we get more done for the same amount of Professor Goldstone: ‘NHS is highly efficient’ money?” Firstly, the system expresses activity in “targets” not volumes, and takes no cognisance of the fact that volumes of activity are constantly increasing. For instance, GPs are carrying out 40 per cent more consultations than 10 years ago. The second strategy is to blame staff: lazy GPs won’t work weekends, consultants are mostly on the golf course and there are too many managers... The Commonwealth Fund has shown that none of this is true.
So what has all this to do with delisting cancer drugs? Many new cancer agents are very expensive and NICE (National Institute for Clinical Excellence) is rightly making a stand against this. But some of the new drugs in myeloma, pancreatic cancer and other malignancies are giving patients hope where there wasn’t any and the delisting is not taking note that these drugs are actually effective. Cost/benefit analysis is all very well but delisting of effective drugs is another matter.
Delisting is devastating to patients and is making UK cancer care an object of derision. Eight or nine of the drugs delisted in the UK two weeks ago (and therefore not available on the NHS from November) are standard treatment in the rest of the advanced world.
The lesson is clear. Tell the public the truth about the NHS — that it is an institution of which Britain should be proud but it is underfunded because of demand — and allow them to debate what they want from it. There are fundamental choices to be made — “pay more” or “get less” — and the worst option is to indulge in silly nonsenses such as to fiddle with the availability of effective cancer drugs.