Minister defends Nice over spending choices

Nov 9 2007 by William Green, The Journal

HEALTH Minister Dawn Primarolo has defended the controversial agency that rules what expensive drugs the NHS can use.

The National Institute for Health and Clinical Excellence (Nice) has come under repeated fire with some patients – including some in the North-East – left without drugs that they believe can help their conditions and extend their lives.

But Ms Primarolo insisted there had to be a “trade-off” in a system where cash was limited and the process used by Nice was “robust” during questioning by the Commons health select committee yesterday.

“In a cash limited system we clearly cannot pay for absolutely everything. So there needs to be an approach which attempts to prioritise on evidence that is available.

“Nice have a role to play in that in starting to shift the debate onto a more robust footing that is about what the evidence tells us rather than who shouts the loudest,” said the minister.

She also said primary care trusts needed to ensure they engaged with local communities to understand their needs and the evidence – with Nice having a “crucial” role in advising on some elements of that.

Ms Primarolo added transparency and engagement was needed to ensure the public understood decisions, although she admitted that was an “incredibly difficult” discussion to have.

Bosses from Nice also defended its record when asked about the apparently quicker process used in Scotland.

They said its system of consultation and appeals were central to its work, which added two months to the process.

“A quick and dirty answer would be unfair and wrong for the NHS and the patients it seeks to serve,” said agency chairman Professor Sir Michael Rawlins, who used to work at Newcastle’s Freeman Hospital and Royal Victoria Infirmary. He stressed the importance of being fair, because treatments that were not cost-effective could mean denying other people.

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Mum refused life extending drug

SOMEONE who knows all too well how Nice guidelines affect patients’ life is Paul Gault, 48, husband of Karen, 43, who was diagnosed with terminal bowel cancer in September.

The couple, who have a three-year-old daughter Grace, were told a drug, Avastin, was her only hope of five more precious years with her daughter.

The NHS, however, is unable to prescribe the drug because Nice guidelines ruled the drug did not present value for money.

The couple, who met at Northumbria University, decided to apply to the NHS under exceptional circumstances, but with time running out, they are trying to raise the £25,000 for Avastin themselves.

Mr Gault said: “I do realize the health service has a finite budget but it is hard to go through the system of exceptional circumstances. There needs to be some sympathy. Nice seems to work just on a cost basis and no other consideration.”

If you can help the Gaults find the remaining £7,000 they need to meet their target, Paul can be contacted on: 07976 612270 or email: gaultpaul@hotmail.com