Leading article: Our health service can no longer dodge reform

The spiralling cost of drugs presents an unavoidable challenge

Share
Related Topics

It is the sort of warning liable to give health ministers sleepless nights. Professor Karol Sikora, the director of a private provider of cancer services, has warned that the National Health Service's bill for cancer drugs could rise to as much as £50bn, swallowing up half of the entire present health budget. The consequences would indeed, as Professor Sikora argues, push the NHS towards "meltdown".

Nor does such a scenario sound particularly far-fetched. The national drugs bill is certainly rising rapidly as new products are brought to the market by pharmaceutical companies. NHS spending on prescription drugs in England has more than doubled in a decade to £8.2bn a year.

The problem is that our collective willingness to pay for healthcare through our taxes is at its limits. At the moment it is the National Institute for Clinical Excellence (Nice), charged with approving new drugs for use on the NHS, which is caught in the middle of these two opposing forces.

Nice's decision last month to reject the NHS's use of four expensive kidney cancer drugs on the grounds that they are not "cost effective" unleashed a storm of anger from patients and consultants. Nice was labelled inhumane for denying patients access to these drugs which have been shown to extend the lives of cancer sufferers by up to six months.

To address this highly emotive criticism, it is imperative that we take a step back and acknowledge some basic realities about our healthcare system. The NHS does not have limitless financial resources. And these resources need to be rationed for the sake of fairness. One might reasonably argue that Nice's cost-effectiveness limits for new drugs ought to be revised. But the bottom line is that if Nice did not exist, it would have to be invented. To argue that the NHS should approve any new drug that has a proven beneficial effect on health, regardless of cost, is irresponsible.

That said, the status quo is plainly unstable. At the moment those patients who pay for expensive drugs privately are denied any supplementary NHS treatment, forcing them to pay yet more from their own pockets. To exclude such patients from NHS treatment seems wantonly cruel. But the unpalatable fact is that to allow them full access to NHS care would be effectively to allow the well-off to "top up" their care, while the poor would be forced to get what they are given. Such a scenario would strain the very concept of an income tax-funded national health service, free at the point of use.

We are in uncharted territory here. The Government's head of cancer services, Mike Richards, is conducting a review of top up payments, due to report next month. But Professor Sikora believes that the only practical way forward is a wholesale restructuring of the NHS and the development of new ways to fund the health service. When one considers the demographic pressures of an ageing society, the rapid advances in medical technology and the increasing price of drugs, it is hard to resist the logic of this argument. With many of the expensive new drugs already available in European health systems, the pressure for reform of the NHS will only grow.

There are several questions that we, as a society, need to answer: what do we want our health service to look like, how do we want to pay for it and what precisely do we want it to do? The urgency of these questions is growing. It is the responsibility of all serious politicians to help develop an answer.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Lead Application Developer

£80000 - £90000 per annum + competitive: Progressive Recruitment: I am current...

Senior Networks Architect

£65000 per annum + 15% Pension, Health, Travel & Bonus: Progressive Recruitmen...

SAP BW/BO Consultant

£55000 - £65000 per annum + Benefits: Progressive Recruitment: SAP BW/BO CONSU...

Hydraulic Power Pack Design Engineer

competitive: Progressive Recruitment: I recruit for contract mechanical design...

Day In a Page

Read Next
 

How silly of me to assume it was Israeli bombs causing all the damage in Gaza

Mark Steel
 

Careful, Mr Cameron. Don't flirt with us on tax

Chris Blackhurst
Dress the Gaza situation up all you like, but the truth hurts

Robert Fisk on Gaza conflict

Dress the situation up all you like, but the truth hurts
Save the tiger: Tiger, tiger burning less brightly as numbers plummet

Tiger, tiger burning less brightly

When William Blake wrote his famous poem there were probably more than 100,000 tigers in the wild. These days they probably number around 3,200
5 News's Andy Bell retraces his grandfather's steps on the First World War battlefields

In grandfather's footsteps

5 News's political editor Andy Bell only knows his grandfather from the compelling diary he kept during WWI. But when he returned to the killing fields where Edwin Vaughan suffered so much, his ancestor came to life
Lifestyle guru Martha Stewart reveals she has flying robot ... to take photos of her farm

Martha Stewart has flying robot

The lifestyle guru used the drone to get a bird's eye view her 153-acre farm in Bedford, New York
Former Labour minister Meg Hillier has demanded 'pootling lanes' for women cyclists

Do women cyclists need 'pootling lanes'?

Simon Usborne (who's more of a hurtler) explains why winning the space race is key to happy riding
A tale of two presidents: George W Bush downs his paintbrush to pen father’s life story

A tale of two presidents

George W Bush downs his paintbrush to pen father’s life story
Restaurateur Mitch Tonks has given the Great Western Pullman dining car a makeover

The dining car makes a comeback

Restaurateur Mitch Tonks has given the Great Western Pullman dining car a makeover
Gallery rage: How are institutions tackling the discomfort of overcrowding this summer?

Gallery rage

How are institutions tackling the discomfort of overcrowding this summer?
Louis van Gaal has £500,000 video surveillance system installed to monitor Manchester United players

Eye on the prize

Louis van Gaal has £500,000 video surveillance system installed to monitor Manchester United players
Women's rugby: Tamara Taylor adds fuel to the ire in quest to land World Cup

Women's rugby

Tamara Taylor adds fuel to the ire in quest to land World Cup
Save the tiger: The day America’s love of backyard tigers led to a horrific bloodbath

The day America’s love of backyard tigers led to a horrific bloodbath

With only six per cent of the US population of these amazing big cats held in zoos, the Zanesville incident in 2011 was inevitable
Samuel Beckett's biographer reveals secrets of the writer's time as a French Resistance spy

How Samuel Beckett became a French Resistance spy

As this year's Samuel Beckett festival opens in Enniskillen, James Knowlson, recalls how the Irish writer risked his life for liberty and narrowly escaped capture by the Gestapo
We will remember them: relatives still honour those who fought in the Great War

We will remember them

Relatives still honour those who fought in the Great War
Star Wars Episode VII is being shot on film - and now Kodak is launching a last-ditch bid to keep celluloid alive

Kodak's last-ditch bid to keep celluloid alive

Director J J Abrams and a few digital refuseniks shoot movies on film. Simon Usborne wonders what the fuss is about
Once stilted and melodramatic, Hollywood is giving acting in video games a makeover

Acting in video games gets a makeover

David Crookes meets two of the genre's most popular voices