NHS sees light and saves couple from choosing who goes blind

An elderly couple who faced having to choose which of them should go blind because they could not both afford sight-saving drugs have finally been saved by the NHS. Olive Roberts, 79, and her husband, Ron, 81, both suffer from wet age-related macular degeneration (AMD), the most common form of blindness in Britain. They were told that the only way to treat their condition quickly enough was to go private. However, the treatment would have cost them more than 14,000 pounds each. They could afford only one course and decided that Mrs Roberts should have it as her sight was deteriorating faster.

Yesterday Wiltshire Primary Care Trust announced that it would fund Mrs Roberts's treatment. The trust denied accusations of a U-turn, but was criticised by campaigners for allowing the couple's condition to deteriorate by taking more than two months to decide. The couple are among tens of thousands of people with AMD who urgently need sight-saving treatment but who say that they have been let down by local health authorities refusing to fund new and effective drugs to treat the condition. The Royal National Institute for the Blind, which supported the couple's case, said that four out of five NHS trusts were denying patients prompt treatment with sight-saving drugs.

Mr and Mrs Roberts had AMD diagnosed after sudden onsets of blindness last year. Mr Roberts, a retired civil servant who served with the RAF and the Royal Navy during the Second World War, was disappointed that the trust had not contacted them directly with the news. "While we are delighted that Olive can receive the treatment she needs, we have been through hell in the past three months, and this highlights the fact that many other people are not getting the help they need."

AMD damages the part of the retina responsible for precise vision. Treatments are approved for use on the NHS in only a quarter of cases and can merely slow the disease's onset. The Roberts were advised that only prompt treatment with the drug Lucentis could prevent blindness. However, it is not approved for widespread use on the NHS. Mr and Mrs Roberts, of Malmesbury, asked Wiltshire Primary Care Trust to fund the treatment, but were told that they would have to wait up to three months for a decision.

Advised to undergo treatment within that time, the couple decided to buy Mrs Roberts a course of the bowel cancer drug Avastin, a cheaper alternative. However, clinical trials have not proved its safety and efficacy in AMD. Paul Jakeman, medical director for Wiltshire trust, said that the NHS would fund Mrs Roberts's treatment with Lucentis. Mr Roberts said that he could now afford to pay for Avastin for himself. "It seems that only those who shout loudest will get this treatment," he said.

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NHS to face elderly care probe

About 25 NHS trusts are to be inspected after concerns were raised about the way they care for older people, the Healthcare Commission has said. The inspections will form part of a wider review for a report published later in the year. The announcement comes after concerns were raised, including some by charities, about the way the trusts treat elderly patients.

The Healthcare Commission already inspects all NHS trusts but they are allowed to self-report on whether they meet core Government standards. These include on privacy, treating patients with respect, and ensuring their nutritional needs are met.

The 25 or so trusts have said they meet the core standards but this will now be verified by the Healthcare Commission. The Commission has given the trusts two weeks' notice that they will be inspected, but not which wards. Inspectors will go through files, observe wards and speak to staff, who will be interviewed anonymously. Trusts that are performing well will also be examined to help inform best practice.

Anna Walker, the Commission's Chief Executive, said: "Let's be clear that the vast majority of NHS staff go to work to look after patients well and make an excellent job of doing so. "But sadly, it is also true that some patients are not treated with the dignity and respect they deserve. That is simply unacceptable in the modern NHS."

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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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