When I talk to constituents, friends and family, it is clear we have all had different experiences with the NHS. Some are terrifying, others comforting, but in the end it is these personal experiences that shape our general view of Britain’s health system. I don’t think anyone would disagree that better patient care — the core aim of the current Health Bill – is a highly desirable goal. However, better quality care cannot be simply defined as more control by medical practitioners. It needs to include real patient power and the highest standards of safety. I don’t think the Conservatives can honestly say that Andrew Lansley’s current plan leads to tangible patient power. It merely transfers powers from administrators to medical professionals — the producer interest.
The British press doesn’t like to miss a tragic NHS story, and here’s one in the making –- a local health authority in the South East is allowing doctors to treat patients suffering from a degenerative eye condition with a drug that was developed and is only licensed as a cancer treatment. The unlicensed treatment is being prescribed by doctors (despite concern expressed by the Royal College of Ophthalmologists) because it costs less than the one approved by the National Institute for Health and Clinical Excellence (NICE), which sets NHS drug policy based on clinical trials. While I’m all in favour of cost-saving in all public services, and I believe that a competitive health market is the only way to deliver the level of reform required to make any real difference, what concerns me about this practice is the willingness to put cost efficiency above the best interest of the patient. It shows a dangerous lack of regard for the process of drug approval.
The eye disease is Wet Age-related Macular Degeneration (“Wet AMD”), a common cause of vision loss in older people. Lucentis, manufactured by Novartis, is the approved treatment. It’s expensive — reported at £900 a shot. But it’s approved for the condition. Cancer drug Avastin is much cheaper. It comes in larger doses and is being divided up in to several treatments via syringe – a process which carries the risk of infection. Older people, the main sufferers of Wet AMD, deserve the best treatment available. According to a recent study, the 65s and older contributed £40 Billion to the UK economy in 2010. At the very least, as patients they deserve the choice – the approved treatment or the cheaper option that might have a similar effect but carries more risk. I know which I would choose.
The NHS has long been a black hole, swallowing billions to pay managers and meet targets seemingly set by people on another planet. The focus on healthcare costs though must not trump patient care, nor undermine the legitimacy of systems in place that ensure medicines are safe and effective. Cameron is yet to prove to us that he and his Health team aren’t still living on that other planet.