MORE NHS PENNY-PINCHING

But there's plenty of money to pay hundreds of thousands of bureaucrats

Cancer charities reacted with anger and disappointment yesterday to new recommendations from the health watchdog not to make two new treatments for bowel cancer available on the NHS. In draft guidance, the National Institute for Health and Clinical Excellence (NICE), said it did not believe that the treatments bevacizumab (Avastin) and cetuximab (Erbitux) were cost effective. The guidance, which is not final and is open to consultation, said that Avastin should not be recommended for use as the primary treatment for somebody with advanced bowel cancer. Erbitux is not recommended for any second line treatment, after other treatments have failed, of advanced bowel cancer.

Ian Beaumont, of Bowel Cancer UK, said the charity was very disappointed at the decision, given the proven efficacy of the drugs and that the UK had been in the forefront of their development. “It looks as if we will, once again, be at the very back of the queue when it comes to being able to make them available to patients. “It is also very hard not to be angry and cynical when NICE appears to be making its decisions on the basis of financial expediency rather than clinical efficacy,” he said.

Joanne Rule, chief executive of the charity Cancerbackup said that the new treatments were already widely available in the private health care sector. The charity Beating Bowel Cancer said that all bowel cancer patients should be entitled to the best course of treatments available to each of them, regardless of their ability to pay.

Andrea Sutcliffe, deputy chief executive of NICE, conceded that Avastin does show some increased benefit over the standard treatment for bowel cancer, but said it did not justify the cost. NICE had been unable to say whether Erbitux was better than any other existing treatments. “Neither of these drugs represents a good use of scarce NHS resources,” 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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