Pat Dollard | Young Americans

Yeah … The socialistic democrats HOPE you aren’t following what’s going on in other countries that already have the FAILED/FAILING healthcare system they are advocating, and if elected they will CHANGE everything you have ever known about open healthcare and choices in healthcare …

Postcode lottery ‘left 1,300 cancer patients to die’

by John Carvel - (Guardian UK)

A postcode lottery in cancer care was revealed yesterday in returns under the Freedom of Information Act showing where in England patients are most likely to be refused innovative drugs that could extend their lives.

The Rarer Cancers Forum found hundreds of cases of patients being denied drugs recommended by their doctors.

Local NHS commissioners have wide discretion over whether to fund drugs that have not yet been assessed by the National Institute for Health and Clinical Excellence (Nice). When refused, a patient can appeal. The forum, a charity, has found that some areas almost invariably grant appeals and agree to pay for the drugs. Other areas veto up to 100% of appeals.

The forum said: “Over 1,300 cancer patients have been left to die in the past 20 months because they were not deemed exceptional enough to receive cancer treatment on the NHS. They will have been forced either to go without the life-giving treatments or to pay privately for the ‘top-up’ drugs and risk having all their other care withdrawn.”

The charity used the FoI Act to obtain full details of appeal decisions by 62 of England’s 152 primary care trusts (PCTs). It found wide variations, even among neighbouring trusts.

The areas where most appeals were rejected included Nottingham (100%), Derby (80%), East and North Hertfordshire (79%), Bexley (79%), Camden (69%) and Bristol (68%). Areas granting every appeal included Wakefield, Havering, Torbay, Kirklees, Shropshire and Warrington.

The charity points out that some PCTs may have a generous policy on funding cancer drugs, so few cases are appealed.

The FoI Act returns showed there were 2,065 appeals to the 62 PCTs, and that 26% were turned down. The charity extrapolated the results across all 152 PCTs to suggest there may have been 5,063 appeals, of which 1,314 were rejected.

Penny Wilson-Webb, the chief executive, said: “The NHS should be available to all who need it. Yet 1,300 cancer patients were denied the treatment that could have made all the difference to them … Thousands of cancer patients have been forced to plead for their lives.”

The investigation found that appeal panels in many PCTs were dominated by managers, who lacked clinical experience of these complex areas of medicine.

Dr Steve Schey, consultant haematologist at King’s College hospital, said some committees tended to let non-clinical factors override clinical considerations.

A Department of Health spokeswoman said the draft NHS constitution would address the problem by speeding up the process of appraising new drugs.

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Patients ’should not expect NHS to save their life if it costs too much’

The NHS should not always attempt to save someone’s life if the cost is too much, the medical regulator has ruled.

By Robert Winnett - (Telegraph UK)

The National Institute for Health and Clinical Guidelines (Nice) has ruled for the first time that saving a life cannot be justified at any cost, in a review of its ethical guidelines.

The ruling - made by the board of the controversial organisation - contradicts advice it received from its own ‘Citizens Council’ which offers advice from a representative sample of the general public.

Nice is facing growing criticism over the number of drugs it is now rejecting which are available throughout Europe and in America. Last week, it refused to sanction four kidney cancer drugs which can double life expectancy.

It has now rejected the so-called “rule of rescue” which stipulates that people facing death should be treated regardless of the costs. The rule is based on the natural impulse to aid individuals in trouble.

In a report on “social values judgement” the regulator says: “There is a powerful human impulse, known as the ‘rule of rescue’, to attempt to help an identifiable person whose life is in danger, no matter how much it costs. When there are limited resources for healthcare, applying the ‘rule of rescue’ may mean that other people will not be able to have the care or treatment they need.

“Nice recognises that when it is making its decisions it should consider the needs of present and future patients of the NHS who are anonymous and who do not necessarily have people to argue their case on their behalf…The Institute has not therefore adopted an additional ‘rule of rescue’.”

The ruling contradicts the advice of Nice’s Citizens Council, which said that a rule of rescue was an essential mark of a humane society. The report said that where individuals are in “desperate and exceptional circumstances” they should sometimes receive greater help than can be justified by a “purely utilitarian approach”.

Doctors have also criticised the ruling. Tony Calland, chairman of the ethics committee of the British Medical Association, said: “We would be opposed to ignoring a rule of rescue when it introduces a degree of flexibility around extreme cases. So what if you waste a few pounds if you are doing your best for humanity?”

Nice defended its ruling last night saying that the Citizens Council provided useful input to its decisions but that the organisation’s role was to determine how best to allocate the health service’s limited resources.

Nice is facing increasing accusations that it is giving undue weight to financial considerations - rather than medical benefits - when making decisions on whether to allow drugs or other treatments on the NHS. Doctors and patients have alleged that they are treated with contempt by the organisation and that life-saving drugs are being unfairly denied.

The Daily Telegraph disclosed yesterday that Nice is preparing to offer patients advice on the medical benefits of drugs that are not available on the NHS. The disclosure is likely to anger patients who face paying tens of thousands of pounds for expensive drugs which may prolong their lives.