NHS or private but not both!

Dec 26 2007 by Paul James, The Journal

A MOTHER who raised £36,000 to pay for additional cancer treatment has been told that she can no longer receive standard care free on the NHS.

Karen Gault, 43, who is fighting terminal bowel cancer, is taking a course of the drug Avastin in a bid to give herself more time with husband Paul and their three-year-old daughter Grace.

The family have been able to raise enough cash for the treatment – which is not available on the NHS – after a fund-raising drive and a massive response from Journal readers to their story.

But yesterday Paul, 48, told how the NHS now deems his wife to be a private patient and will not fund the chemotherapy and drugs she was receiving before starting the £25,000 treatment 10 weeks ago.

The family said they had been overwhelmed by the response to their story, with strangers from across the world sending cheques in the post to Newcastle that have taken their fund £11,000 past their initial target.

But Paul, a Gateshead Council engineer, now estimates they will need to find an extra £5,000 a month for Karen’s care.

Avastin is a licensed NHS drug, but the National Institute for Health and Clinical Excellence (NICE) says it is not value for money. It leaves the treatment decision to local health trusts.

The £25,000 is paying for nine treatments, which Karen believes could give her up to five extra years with her family.

Paul, who met his wife when they were students at Northumbria University, said: “I thought this was some kind of sick joke and that they were taking the mickey out of us.

“If you go for a private drug you effectively drop out of the NHS. I’m not medically qualified but it took me five minutes to pick holes in that argument. You can pay a dentist extra for a fancy crown, you can take IVF drugs into the NHS.

“I’ve written to the medical director of the Primary Care Trust and asked if, as an interim measure, he would pay for the standard chemotherapy that the trust would pay for anyway. Otherwise we’ll be paying £5,000 a month.”

Karen, a former health service administrator, came out of hospital after her latest treatment last week and the family will be spending Christmas together at home in Jesmond Dene Road, Jesmond.

A Newcastle Primary Care Trust spokeswoman said: “Whilst we understand that it is distressing for patients to be told that a drug will not be made available, we need to take into consideration the real clinical benefits a drug may provide. Unfortunately we are advised in this case that Avastin is not an effective chemotherapy treatment for colorectal cancer.

“The use of Avastin was rejected earlier this year by NICE as a chemotherapy treatment for colorectal cancer – NICE gives guidance on the appropriate treatment and care of people with specific diseases and conditions for the NHS.

“Consultants can make a direct application on behalf of their patients to the local Primary Care Trust for the treatment to be provided as an exception. The information provided by the patient’s consultant is considered by the PCT medical director. If the decision is not to fund a treatment then an appeal can be made to the PCT to reconsider – and further information provided.

“Cancer consultants will be able to advise their patients about an appeal and we would always urge patients to discuss their alternative treatment options with their consultant.”

The Government is opposed to the so-called “co-payments” because they would lead to patients in the same NHS ward receiving different drugs based solely on their ability to pay. A Department of Health spokeswoman said: “There are more treatments than ever available on the NHS and cancer treatment and survival rates have improved dramatically.

“Any publicly funded healthcare system has to make difficult decisions about what treatment should be available. These decisions are made by the independent National Institute for Health and Clinical Excellence.

“It is a fundamental principle of the NHS, now supported by all the main political parties that treatment should be free at the point of need.

“Co-payments would undermine this principle as they involve an element of subsidy of private treatment by the taxpayer. People have always been free to choose to pay for private treatment if they wish.”