Drug victory for patients: ‘Penny-pinching’ NICE stripped of power to ban life-saving drugs
The scandal of patients being denied drugs just because the NHS rationing body decides they are too expensive will end, ministers have declared.
In a stunning victory for patients – following a campaign by the Daily Mail – the controversial organisation NICE will be stripped of its powers to ban drugs on the Health Service. And the current arbitrary limit on the cost of new drugs – around £30,000 per year of extended high-quality life – will be scrapped from 2014.
The decision will end the ordeal of tens of thousands of patients being denied life-extending drugs every year, even though their clinician believes they could help them.
It also raises hopes that no patient will ever again have to hear the dreaded news that a medicine on which they have pinned their hopes will be refused because it is not ‘cost effective’
Critics blame decisions by the ‘penny-pinching’ National Institute for Health and Clinical Excellence for the UK’s appalling record on cancer survival, which sees patients denied innovative new drugs that are available freely in Europe.
Decisions by NICE have triggered a series of high-profile battles in which it has attracted the anger of patient groups and become a byword for a heartless NHS which puts number crunching above patients’ lives.
NICE originally turned down the breast cancer drug Herceptin, blindness drugs Macugen and Lucentis, and three drugs for dementia sufferers costing just £2.50 a day, only backing down after high-profile campaigns.
Cancer charities say 20,000 patients die early needlessly every year because of NICE decisions. But the Department of Health now says that NICE would no longer be ‘acting as an arbiter on the availability of drugs’, with GPs instead deciding what the NHS could afford.
While campaigners welcomed the development, there are concerns the plans could lead to a postcode lottery, with patients in some areas being refused drugs available elsewhere.
Last week, Health Minister Earl Howe let the cat out of the bag when he described NICE as becoming ‘somewhat redundant’ when a new method of paying for drugs comes on stream in 2014.
Under the ‘value-based pricing’ regime government officials will negotiate with pharmaceutical companies to agree a price, based on a drug’s effectiveness and other factors, such as how it reduces the burden on carers.
It is hoped the scheme will bring down the prices of ‘wonder’ drugs by allowing them to be sold more cheaply until the evidence of their effectiveness grows, allowing more to get access to them earlier. At present NICE restricts their use until the evidence they work is overwhelming, causing massive delays. It also means an end to the current system where a drug cannot be funded if it costs more than £30,000 per extra high-quality year of life.
Clive Stone, of Justice for Kidney Cancer Patients, described the news as ‘excellent’. He added: ‘It has taken me by complete surprise, especially after all our battles for access to cancer drugs. Has David beaten Goliath?’
Health Secretary Andrew Lansley said: ‘We will move to an NHS where patients will be confident that where their clinicians believe a particular drug is the right and most effective one for them, then the NHS will be able to provide it for them.’
After 2014, NICE will be reduced to advising doctors on which drugs are most effective.
Groups of GPs – consortia – will be responsible for deciding whether a drug should be funded or not. These consortia will be in charge of spending NHS money in their areas after 2013.
They will be allocated more than £70billion of funding, divided up according to each area’s population and level of ill-health. Out of this they will fund everything, from hospital operations, to district nurse visits, to drugs.
However, while doctors are happy that patients will get access to more drugs, they are worried about being involved in cost-effectiveness decisions. Dr Richard Vautrey, of the British Medical Association’s GP committee, said the Government ‘risks misleading the public’. ‘When it comes to high cost drugs, whether it be NICE or consortia making decisions, the reality is the money is simply not available for everyone to have everything that they want,’ he told GP magazine.
Health economist Alan Maynard added: ‘Real growth in the NHS will be about 0.5 per cent in the next few years. We’re going to have rationing. The question is whether we have it at a national level or let 150 primary care trusts or whatever do it their own way.’
Sir Andrew Dillon, chief executive of NICE, said: ‘NICE is the global leader in evaluating the benefits of new drugs and we anticipate being at the heart of the new arrangements.’
Don’t get toothache in Britain
Britain’s NHS dentistry mess
Tens of thousands of patients are seeking hospital treatment for their teeth after failing to find an NHS dentist. Emergency admissions have increased by 40 per cent over the past decade, according to official figures seen by the Daily Mail.
Some 24,292 patients were treated in casualty in 2009/10, compared with 17,400 in 2000/2001. Shockingly, some patients were admitted to wards after trying to pull out their own teeth.
Today, Health Secretary Andrew Lansley will vow to tear up contracts that have made dentists rich, saying botched Labour reforms have made it even harder to get care on the Health Service. ‘These figures provide more evidence that the previous Labour government failed to improve access to NHS dentistry,’ he told the Daily Mail.
‘While some emergency admissions are to be expected, the sheer level of increase suggests that fewer people are getting the dental care that they need.
‘The coalition Government will not delay in reversing this. That’s why we are committing to introducing a new dentistry contract that will focus on achieving good dental health and increasing access to NHS dentistry, with an additional focus on the oral health of schoolchildren.’
The new dental contract, officials say, will be based on registration of NHS patients, quality of treatment and a fixed fee per individual treated.
Details are expected to be published by the end of the year. There is growing concern about the desperate state of NHS dentistry a decade after Labour pledged all patients would, within two years, have access to treatment on the Health Service.
Labour drew up a contract for dentists in 2006 designed to improve efficiency but it resulted in patients finding it far more difficult to get an appointment on the NHS. A million people are thought to have lost access to an NHS dentist.
Figures from the NHS Information Centre suggest that regions where there has been a bigger increase in the number without an NHS dentist have tended to see a larger rise in the number of hospital admissions for dental treatment.
Before the reforms of April 2006 there were up to 400 differently priced items for which dentists were paid. The new contract reduced this to just three bands of treatment – £15.90 for a basic examination and x-rays, £43.60 for root canal work or other treatment and £194 for work such as crowns. That means patients now face a minimum charge of £15.90, where previously they could pay as little as £6 for a check-up.
Dentists complain the contract does not reflect the amount of work they actually carry out. For example, they receive the same amount of money regardless of whether they provide a patient with two fillings or ten.
Many dentists have left the NHS, complaining they are not being properly paid. Mr Lansley also believes that perverse incentives mean some dentists skip essential preventative care to meet short-term targets for other treatments.
Over the past four years the average pay of dentists has risen 10 per cent to almost £90,000, according to the NHS Information Centre. More than one in ten dentists is earning more than the Prime Minister – and hundreds earn more than £300,000.
The number of dentists who have broken through the £300,000 barrier has gone up by 10 per cent in the past year. A total of 410 now earn above £300,000, while 2,410 are on more than £150,000.
Yet dental care appears to have suffered for those without access to an NHS dental practice.
In 2007, a great grandmother from Scarborough told how she pulled a tooth with a pair of pliers from her husband’s toolbox after drinking beer as an anaesthetic. Valerie Holsworth said she had repeated the painful operation six times. ‘It is just a matter of tugging and wiggling until the root comes loose,’ she said.
Homosexual rights laws are ‘a danger to our freedoms’
British Bishops speak out after Christian couple barred from fostering children because of their views on homosexuality go to court
Gay rights laws are eroding Christianity and stifling free speech, Church of England bishops warned yesterday. Senior clerics, including former Archbishop of Canterbury Lord Carey, spoke out ahead of a High Court ‘clash of rights’ hearing over whether Christians are fit to foster or adopt children.
The test case starting today involves a couple who say they have been barred from fostering because they refuse to give up their religious belief that homosexuality is unacceptable.
Supporters hope their legal challenge will set a precedent for the rights of Christians to foster children without compromising their faith. But senior bishops fear that if the ruling goes against them, it could have devastating consequences for those with religious beliefs. Either way, they believe the case will determine whether Christians can continue to express their beliefs in this country.
In an open letter, they warned that Labour’s equality laws put homosexual rights over those of others, ‘even though the Office for National Statistics has subsequently shown homosexuals to be just one in 66 of the population’.
The letter is signed by Lord Carey, the Bishop of Winchester Rt Rev Michael Scott-Joynt, the Bishop of Chester Rt Rev Peter Forster, and Rt Rev Michael Nazir-Ali, the former Bishop of Rochester.
They wrote: ‘The High Court is to be asked to rule on whether Christians are “fit people” to adopt or foster children – or whether they will be excluded, regardless of the needs of children, from doing so because of the requirements of homosexual rights. ‘Research clearly establishes that children flourish best in a family with both a mother and father in a committed relationship. ‘The supporters of homosexual rights cannot be allowed to suppress all disagreement or disapproval, and “coerce silence”.’
The couple in the High Court test case, Eunice and Owen Johns, said Derby City Council’s fostering panel rejected them as carers because they would never tell children a homosexual lifestyle was acceptable. Mrs Johns said: ‘The council said: “Do you know, you would have to tell them that it’s OK to be homosexual?” ‘But I said I couldn’t do that because my Christian beliefs won’t let me. Morally, I couldn’t do that. Spiritually I couldn’t do that.’
The Pentecostal Christian couple from Derby, who have fostered almost 20 children, are not homophobic, according to the Christian Legal Centre, which has taken up their case. But they are against sex before marriage and do not recognise as marriage civil partnerships between gay couples.
Their beliefs are at odds with Derby City Council’s equality policy, which was drawn up under the terms of the Sexual Orientation Act brought in by Labour.
The Christian Legal Centre, which campaigns for religious freedoms, said in a statement: ‘The case will decide whether the Johns will be able to foster without compromising their beliefs. ‘The implications are huge. It is no exaggeration to say that the future of Christian foster carers and adoptive parents hangs in the balance. ‘It may not be long before local authorities decide that Christians cannot look after some of the most vulnerable children in our society, simply because they disapprove of homosexuality.’
However Ben Summerskill, chief executive of gay rights charity Stonewall, said: ‘Too often in fostering cases nowadays it’s forgotten that it is the interests of a child, and not the prejudices of a parent, that matter. ‘Many Christian parents of gay children will be shocked at Mr and Mrs Johns’s views, which are more redolent of the 19th century than the 21st.’
The case is due to be heard in the High Court sitting at Nottingham Crown Court.
British fox hunting ban set to stay as repeal campaign ‘falls off political agenda’
A ban on hunting with dogs is likely to remain despite the change in Government because worries about the nation’s finances have forced the issue off the political agenda, campaigners admitted. The impact of the economic downturn has meant attempts to change the controversial law have become a low priority, the Countryside Alliance acknowledged.
As the traditional start of the season gets under way today, the Alliance conceded it was keeping a low profile because it was foolhardy to make hunting a priority issue when country was just recovering from a recession. Officials admitted that for many living in the country, the issue was “not at the top of the agenda” as many families struggled financially.
Earlier this month, the new head of the Countryside Alliance Alice Barnard, 33, told the Daily Telegraph that David Cameron needed to “right a great wrong” by overturning the ban on hunting with dogs.
But within Tory ranks, traditionally seen as pro-hunting, dissent to overturn the ban, introduced under the Hunting Act 2004, appears to be growing. On Sunday it emerged that only a minority of MPs – 253 out of 650 – are committed to repealing the Act with at least 22 Conservative MPs are among more than 300 who would vote against repealing the law.
Opponents of hunting claim that less than one in five people would support a repeal of the ban. A YouGov poll for the League Against Cruel Sports (Lacs) found that 37 per cent believe the ban is an infringement of civil liberties while 17 per cent want to see the hunting ban properly enforced.
The Alliance contested the findings but a spokeswoman admitted that negotiations for a change in the law were now being undertaken more “behind the scenes”. “At the moment certainly with the economic situation we are facing, the countryside is more concerned about having a job and ensuring they have enough money to put fuel in their machinery than how we kill a fox,” she said.
“The priorities at the moment have changed and we understand we are not top of the pile in terms of those priorities at the moment. “But we are still actively undertaking discussion with people as to why this is a bad law and we are doing that more behind the scenes.”
She added: “Maybe if Labour had not spent 700 hours talking about this law then the economy might not be in this state in the first place.”
Douglas Batchelor, the chief executive of Lacs, claimed that attempts to reverse the ban were a “pipe dream”.
Speculative study of almond skins
This appears to be an experiment in laboratory glassware, a long way from a double blind trial
A new study has revealed that naturally occurring chemicals found in the skin of the nut boost the immune system’s response to such infections. Researchers found almond skins improved the ability of the white blood cells to detect viruses while also increasing the body’s ability to prevent viruses from replicating and so spreading inside the body.
They discovered that even after the almonds had been digested in the gut, there was still an increase in the immune system’s defence against viruses.
The scientists, who are based at the Institute of Food Research in Norwich and the Policlinico Universitario in Messina, Italy, said their findings suggest that the nuts can increase the immune system’s ability to fight off a wide range of viruses, including those that cause flu and the common cold.
They said although they have still to carry out research on how many almonds must be eaten to obtain a beneficial effect, it was likely that eating almonds regularly could help protect people from becoming infected with viruses in the first place, while it could also help those already infected to fight off their illness.
Dr Giuseppina Mandalari, from the Institute of Food Research, said: “Almond skins are able to stimulate the immune response and thus contribute to an antiviral immune defence.”
The researchers, whose work is published in the scientific journal Immunology Letters and was funded by the Almond Board of California, found that even after digestion in a laboratory simulation of a human gut, the almonds skins were still able to increase the immune response.
They tested the immune response to infection by the Herpes Simplex Virus 2, which can cause cold sores and is a notoriously difficult virus to treat due to its ability to evade the immune system by dampening down the body’s inflammatory response.
They found that almond skin extracts were effective against even this virus. But they found that almond skins that had been removed through blanching in boiling water, which is common process to remove skins from almonds, had little effect on the immune system.
The researchers say they are still to identify exactly what it is in almond skins that cause the antiviral activity, but they believe it could be due to compounds known as polyphenols.
It is thought they increase the sensitivity of white blood cells known as helper T cells, which are involved in fighting off viruses. They said it was likely that other nuts may also have this sort of activity.
Dr Martin Wickham, who was also involved in the study at the Institute of Food Research, said: “It is an area of huge interest to find natural alternatives that will have an antiviral activity. “Nutritional guidelines recommend eating around three ounces a day to benefit from the fibre and other nutritional components in almonds, but we have still to do the work to see whether this would be enough to have an antiviral affect.
“This was just an initial study to find out if almond skins have this antiviral activity. “The herpes simplex virus is a very good model of viral infection because it is known to evade the immune system, so because the almonds had an impact on this virus, it is fair to assume that it will have an impact on other viruses.”
Putting clocks back is ‘bad for health’
Mayer Hillman is an elderly Greenie nut with an academic background in architecture and a contempt for democracy — but what he says below seems broadly reasonable as far as I can see
The health and wellbeing of the nation would “vastly” improve if the clocks did not go back this weekend, a doctor has said. Remaining on British Summer Time would mean adults had on average 300 more useful hours of daylight and children had 200 more hours, a doctor has said in the British Medical Journal.
This would allow for more exercise and outdoor activities which boost both physical health and mental wellbeing.
Dr Mayer Hillman, senior fellow emeritus at the Policy Studies Institute, in London, said an extra hour of light in the evening would benefit children – a number of whom are not allowed to leave their homes after dark – because they will be able to engage in outdoor activities for longer.
In addition, elderly people who do not go out in the dark for fear of assault and poorer vision and hearing would have more time to take part in leisure and social activities.
Dr Hillman said research showed people felt happier, more energetic and had lower sickness rates in the longer and brighter days of summer compared to the shorter days of winter. He said: “Adopting this proposal for a clock change is an effective, practical, and remarkably easily managed way to better align our waking hours with the available daylight during the year.
“It must be rare to find a means of vastly improving the health and wellbeing of nearly everyone in the population – here we have it – and it only requires a majority of MPs walking through the ‘ayes’ lobby in the House of Commons.”
According to Hillman, there is strong public support for the clock change – about 4 to 1 people in England and Wales would like to see the change while those in Scotland are evenly divided.
Campaign group Lighter Later argue that changing the clocks to Greenwich Mean Time (GMT) +1 in winter and GMT +2 in summer would have a wide-reaching impact.
Up to 80,000 new jobs could be created in the tourist industry, as longer evenings would extend the tourist season and allow attractions to stay open for longer, said campaigners.
In Britain, up to 100 road deaths could be prevented annually while 447,000 tonnes of CO2 pollution could be cut because people would be switching their lights on later, said campaigners.
Britain’s top government schools will now be allowed to expand
The best state schools will be allowed to expand to meet demand for pupil places for the first time, it can be disclosed. Under plans being drawn up by Michael Gove, the Education Secretary, primary and secondary schools will be freed from limits imposed by councils and be able to take on more students. Top-performing schools will be allowed to accept a greater number of students, and gain tens of thousands of pounds extra funding.
Successful schools are likely to get bigger, as more pupils flood in, while poor-performing schools could see numbers decline sharply and be forced to close. Complex admissions procedures will also be simplified to make them less bureaucratic and easier to understand for parents.
The news came as applications closed for places at secondary schools for next September in many parts of England and Wales. Tens of thousands of children are likely to miss out on their first-choice school because the best are oversubscribed. An estimated 100,000 children did not get into their first-choice school last year.
A report published today by the admissions watchdog said hundreds of families were complaining over schools’ admissions rules. Ian Craig, the adjudicator who runs the complaints process, said there were nearly 400 objections to admissions decisions last year.
The new plans to allow the best schools to take more pupils will form part of an education White Paper to be published later this month. Normally, the number of pupils that state schools can take is set by local authorities and can be exceeded only in exceptional circumstances. However, there is concern in Whitehall that councils are limiting the success and size of popular schools to stop them draining pupils from inferior schools nearby.
Under the new plans, top schools will be to be allowed to convert to academy status so they can scrap their fixed admission numbers and take more pupils, as long as there is physical room for them. This will earn the schools tens of thousands of pounds of extra funding and, say ministers, allow more children to benefit from a good education.
Mr Gove hopes the move will force councils to address quickly why poorer schools are failing. However, it could cause tension with Liberal Democrats if poorer-performing schools suffer. “The key problem is that there aren’t enough good school places,” a government source said. “That’s why we’re letting schools expand to meet demand. Good schools will grow, while those that aren’t performing will have to improve.”
Mr Gove wants to simplify the 86-page admissions code, which was toughened up under Labour to stop parents lying about their address or church attendance to secure places for their children. Officials say it can be made simpler without being watered down.
There is a BIG new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.