BRITAIN'S GOVERNMENT-RUN HEALTH INSURANCE LEAVES CANCER SUFFERERS IN THE LURCH

Maintaining their vast bureaucracy matters more to them than curing the sick

Joanne Lees, a pay-roll clerk, relies on the National Health Service. But, as she has discovered, deep pockets can be required here, too - particularly if the worst does occur. When she received a telephone call at work in August last year asking her to go to hospital immediately, she expected to receive bad news. But she did not expect it to be quite so awful. Lees, 31, learnt that she had a fast-growing tumour in her right breast. She had a mastectomy a couple of weeks later; but there were two complicating factors.

First, she was six months' pregnant. Her baby son Nathan had to be delivered by caesarean section 10 weeks early so that she could undergo chemotherapy and radiotherapy. Additionally, it was her second bout of cancer. She had lost her left breast when she was 26. Lees had a quiet Christmas with Nathan and her husband Sean, but thought that she might not be around to enjoy another one. She was told that the likelihood of the disease returning was 81%.

Her breast cancer nurse offered a glimmer of hope, however. Early results from clinical trials showed that a new drug, Herceptin, could reduce the chances of cancer coming back in some patients. A test showed that Lees was positive for the HER-2 gene, which put her among the 25% of breast cancer patients who could benefit from this new wonder drug. Her oncologist at the University hospital of North Staffordshire was prepared to prescribe the medicine. There was just one problem: the NHS would not pay for it.

Lees and her husband had no idea where they would find the 40,000 pounds asked for a two-year course of treatment. "We are just a normal family," she said. "Very few people would be able to pay for this medicine from savings." They were not alone, however. Family, friends, colleagues and even their local pub in Alsager, Staffordshire, have rallied round. With their help, Lees is paying for her Herceptin on a three-weekly basis. If necessary, the couple will remortgage their home to meet the next instalment.

The potential burden is enormous. If the optimistic predictions of experts are correct, Lees could be taking Herceptin, at a cost of 20,000 pounds annually, for years to come. "I don't dare think about the future. I want to be here for my little boy. All I am asking for is the chance to be there for Nathan, to see him grow up," she said.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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