Pensioner 'must go blind to get NHS treatment'

A pensioner will have to lose his sight in one eye before health chiefs will consider treating him, a leading charity for the blind claimed yesterday.

Leslie Howard, 76, from Acomb, York, was diagnosed with wet age-related macular degeneration (AMD) in his right eye last November.

He needs special drugs to save his sight but it is claimed the local primary care trust (PCT) will only consider funding them once he has gone blind in one eye and developed wet AMD in his second eye.

The Royal National Institute of the Blind (RNIB) claims Mr Howard's only hope is to pay for private treatment - wet AMD can cause sight loss in as little as three months and requires prompt treatment.

But Mr Howard, who has been in public service most of his life, says he cannot afford the private care bill of more than £6,000 a year.

Mr Howard said: "I can't believe I'm being left to go blind in one eye. I've spent most of my working life devoted to public service - I was in the Army, police and prison service - and I've never failed to pay my dues.

"I've paid literally tens of thousands of pounds in taxes and to know that I will now lose my sight because I can't afford private treatment is diabolical.

"Has the Government lost all sense of compassion as well as economics? Is there no way I can get help to save my sight?

"My wife and I have arthritis of the spine and if I lose my sight, we'll end up housebound, and that will destroy us."

Steve Winyard, head of campaigns at RNIB, said, "This is a desperate situation for Mr Howard. His PCT is leaving him to go blind in one eye even though sight-saving treatments are available on the NHS.

"It's unacceptable that older people can only save their sight if they can afford private treatment.

"We hear of more and more cases where patients are being forced to use retirement funds or life savings to pay for sight-saving treatments that should be available readily on the NHS.

"In cases like Mr Howard's, where people can't afford private treatment, patients face the prospect of going blind unnecessarily."

Tom Bremridge, chief executive of The Macular Disease Society, said: "The so-called 'second-eye' policy is wholly unacceptable on ethical and practical grounds. People mustn't think that losing sight in one eye isn't that bad - it can affect coordination and increase the risk of falls."

The society said not treating wet AMD in the first eye also carries other dangers because patients have a high risk of developing the condition in the second eye. If treatment is unsuccessful in the second eye, people may end up losing their sight in both eyes.

Mr Winyard added: "The actions of the PCTs are simply unacceptable. There is a moral imperative to save the sight of people where we can. It also makes no economic sense to deny treatment. The cost of supporting people with sight loss far outweighs the cost of treatment."

In a statement, the North Yorkshire and York Primary Care Trust said: "The Department of Health issued revised guidance on managing the introduction of new healthcare interventions in December 2006.

"This advises NHS organisations that until the National Institute for Health and Clinical Excellence (Nice) has published final guidance on a treatment, NHS bodies should continue with local arrangements for the managed introduction of new technologies.

"Nice has published guidance for the treatment of AMD using Photo Dynamic Therapy (PDT), which uses light to activate a medicine that destroys the abnormal blood vessels which cause the disorder. North Yorkshire and York Primary Care Trust fully complies with this guidance.

"However, there is no Nice guidance for the treatment of age-related macular degeneration with anti-VEGF drugs. In agreement with other PCTs in the region, North Yorkshire and York PCT has agreed to fund anti-VEGF drugs for patients for whom it has been evidenced that this will be an effective treatment. This is based on an assessment of the patients against an agreed clinical criteria established by the PCTs.

"If any patient feels they should be considered for treatment outside of the criteria the PCT has an agreed a process to consider their individual circumstances.

"The PCT has committed to review this process following the publication of any Nice guidance."

A spokesman for Nice said anti-VEGF drugs, such as pegaptanib and ranibizumab, were deemed safe to use, but an assessment of their value for money was still ongoing. The anticipated publication date for this appraisal is September.

The spokesman added: "Nice cannot issue guidance on new drugs until they have been licensed. In the absence of Nice guidance, local prescribing arrangements are followed.

"The Department of Health has, however, made it clear that it is unacceptable for primary care trusts to use the absence of Nice guidance as an excuse not to prescribe.

"Equally, there is no ban on the prescribing of drugs that have not been assessed by Nice."

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