The health rationing watchdog has come under attack for spending more money on spin than on evaluating drugs which could save patients' lives. The National Institute for Health and Clinical Excellence (NICE), which has been widely criticised for banning drugs from NHS use as too expensive, squandered 4.5million pounds on 'communications' last year. This was 1.1million more than the 3.4million the controversial organisation spent on assessing new medicines.
The money forked out on press officers, marketing executives and consultants included 25,000 on top public relations firm Weber Shandwick to defend NICE's ban on Alzheimer's drugs. It could have paid for 5,000 Alzheimer's sufferers to get 2.50-a-day drugs for a year. Alternatively it would have funded nearly 200 patients with advanced kidney cancer to have a drug for 12 months that would double their life expectancy. Tens of thousands of people across the country are waiting for NICE to assess drugs that could extend their lives or alleviate conditions such as rheumatoid arthritis and thinning bones.
MPs, patients groups and medical organisations branded the amount spent on communications as a 'scandalous waste of money'. Myeloma sufferer Jacky Pickles, one of the 'Velcade Three' - three mothers who launched a campaign after being denied anti-cancer drugs - said: 'It is disgraceful that money which could provide drugs that make the difference between someone living and dying is being spent on communications.' Mrs Pickles, 46, of Keighley, West Yorkshire, added: 'NICE should either use the money to improve their evaluation process, or give it back to the NHS to spend on people who are ill.'
Shadow Health Minister Mark Simmonds, who uncovered the budget breakdown tucked away in NICE's annual report, said: 'These figures typify New Labour's approach to Britain's health service. 'Thousands of patients across the country who are still waiting for NICE to evaluate new medicines will rightly be asking why Labour insists on spending more on spin than on speeding up people's access to lifesaving drugs.'
NICE has an annual budget of 34.4million pounds, and spends 1 in every 8 pounds on communications. In contrast, 1 in every 10 is spent on evaluating new drugs. The rest is spent on such things as salaries - NICE's annual report for 2006/07 revealed that wages accounted for almost 37 per cent of the budget - accommodation (eight per cent) and external contracts. Almost 300 full-time staff are employed in London and Manchester.
The watchdog looks at whether drugs are cost-effective for the NHS, with the annual cost threshold set between 20,000-30,000 pounds, above which they are considered too expensive. The 'value-for-money' calculation, which does not take into account factors such as severity of a disease, means British patients are denied drugs that are freely available abroad.
NICE was condemned recently for handing a 'death sentence' to 1,700 patients with advanced kidney disease each year who will be deprived of four life-extending drugs. One, Sutent, which costs around 24,000 a year, can double the life expectancy of patients to 28 months.
NICE has also been accused of 'dithering' over the evaluation process. It has taken several years for the watchdog to approve the use of some drugs. Chief executive Andrew Dillon was forced to make a grovelling apology last month for a two-year delay in approving a new treatment for blindness during which time many Britons lost their sight.
Michael Summers, vice-chairman of the Patients Association, said spending 4.5million on communications was 'immoral and indefensible'. He said: 'If NICE has reached the situation where it is so unpopular that it has to spend money improving its image, maybe it should be less dilatory and improve its performance.'
Nick Rijke, of the National Osteoporosis Society, said: 'I would have thought that an organisation that spends so much on communicating would be rather better at listening to the views of clinical experts and patient societies.'
NICE said the majority of its communications budget was spent informing doctors about which drugs had been approved and new guidelines for treatments, although it admitted that it had a 'small' marketing budget.
Mr Dillon said: 'The actual cost of assessing new drugs for the NHS includes money spent on NICE's behalf by the Department of Health. When you add them together, the total cost of the NICE technology appraisal programme far outstrips the cost of NICE communications.'
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Australian public hospitals kill as many as the roads do
The number of deaths caused in Australian hospitals by emergency department overcrowding is equal to the road toll, a new report has revealed. The report by the University of New South Wales, in preparation for a Friday summit on emergency department access block in Melbourne, also revealed that patients face up to 30 per cent more chance of dying if they attend an over crowded emergency department. Children and the elderly are among those most likely to be affected. Queensland hospitals are among the most overcrowded in the country.
The report, prepared for the Australasian College of Emergency Medicine, suggested that increasing hospital bed numbers is the only method to reduce access block. Access block is when patients are left to wait longer than eight hours for a bed in an emergency department. "A large amount of human suffering (in emergency departments) is preventable," the report said. "There is a 20-30 per cent excess mortality rate every that is attributable to access block and ED overcrowding in Australia. "This equates to approximately 1500 deaths per year, which is similar to the road toll."
The report criticised a lack of extra hospital beds in recent years despite enormous growth in emergency department patient presentations. Bed occupancy rate should not be higher than 85 per cent. "There are not enough available beds to meet demand," the report said. "This results in access block and ED overcrowding. "This is associated with significant mortality and human suffering."
The report claimed that telephone hotlines and after-hours GP clinics did little to improve access block. It also criticised methods of treating patients in non-treatment areas such as hospital corridors and waiting rooms. "Access block and overcrowding have also been associated with increased return rates of hospital re-admissions, return visits to the ED, and inappropriate follow-up care," the report said.
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