Friday, 28 April 2017

Should Exotic Cancer Treatments be Provided by the NHS?

An interesting report came out today, regarding the National Cancer Fund.

It seems the initial aim was a laudible one, to provide expensive cancer treatments for patients with terminal cancer in an effeort to prolong their life. But in some cases the drugs actually shortened  their life, the exact opposite of the desired outcome.

But, it seems the outcomes didn't justify the cost. It's now been branded a waste of money. Like most knee-jerk reactions to public opinion.

This is what I've banged on about before: there needs to be a grown up debate on what the NHS is for and especially where the limits lie with respect to treatment. The NHS was initially designed to be a safety net, treating those that couldn't afford private doctor's bills.

As medical advancements have arrived, it's been assumed that the NHS will offer those as well, to the point it offers very expensive, world-class treatments courtesy of the tax payer. Can the NHS afford such expensive treatments, or should there be limits. Should people that want world-class medical care take out medical insurance instead of demanding the NHS provide it?

Take the case of the cancer drugs above. If the people are being used as Guinea Pigs for new cancer treatments, shouldn't the drug companies be funding the supply of the drugs out of their own pocket? Sure the NHS can supply the doctors and share the information gleaned from treatment, but why should the NHS actually be paying quite heavy costs for the supply of the drugs.

The fact that the outcomes in some cases were negative shows that these are not sure-fire treatments, that the drugs involved were administered without any clear benefit. In that case it's not treatment, it's a trial and the drug companies should be paying or supplying the drugs for free.

There also needs to be a debate about treatment for terminal patients. Should we be spending tens of thousands of pounds on exotic drugs to prolong the life of someone that is never going to recover? If it was a cure, then the cost may be justified, due to the reduced cost of ongoing treatment. But the money shouldn't be going into vastly expensive trials. Shouldn't that money be going into treatments with a more definate outcome and a long-term benefit, for instance hip and knee operations?

It seems to me a bit selfish for someone that already knows they are are terminally ill to demand from the NHS hideously expensive drugs on the off chance that they may (or more likely will not) extend their life by a few months at most, at the expense of providing a long-term (deceades-long) benefit to people that have other, cheaper treatments like hip and knee operations.

If you want that sort of top-class service, then buy medical insurance.

Of course I'm going to be whinged at by those that see this as a two-tier health service: the people able to afford health insurance will get better treatment, those that can't get bargain basement treatment on the NHS. But expecting the NHS to supply top-class service for the whole population is wrong too. Where does it stop? At what percentage of government expenditure do we say enough is enough?