Leading article: The NHS should explain

Related Topics

Many breast cancer patients are delighted by the approval of Herceptin for NHS use. But the joy of this newspaper, which campaigned on their behalf, is bounded. In a minority of cases of early breast cancer, Herceptin is an effective treatment. The difficulties arise because it is only the most famous of a new family of drugs already proven effective against different forms of cancer.

Herceptin was given fast-track approval by Nice, the National Institute for Clinical Excellence. It is hard to avoid the suspicion that the procedure was accelerated partly by lobbying by popular cancer charities and by a media campaign for a fashionable cause. The Independent on Sunday played a leading role in that campaign, of which we are proud, but the Herceptin decision is very much the beginning of a victory rather than an occasion for lasting self-congratulation.

Today, we return to the question of the 20 other cancer drugs that are still waiting for Nice approval. In none of these cases does there appear to be doubt about the effectiveness or the safety of the treatment. On page 13, we report the case of Tamar Bailey, who died last week, and whose 26-year life could have been prolonged by early treatment with Avastin, a drug that shrinks tumours. But Avastin is still waiting for Nice approval, and so Tamar's primary care trust refused to pay for it.

Of course, Avastin is expensive. It costs £20,000 a year per patient. We do not argue that all treatments that could extend lives - or even all treatments that could extend the lives of young people - should be funded. If Nice decides that public money could secure better quality of lives elsewhere, that would be a decision that could be debated and challenged. What is not acceptable, though, is to use bureaucratic delay as a way of rationing by stealth.

As we have argued before, openness is the key. Everyone accepts that limited NHS resources have to be prioritised; what matters is that the process by which such priorities are set commands respect. The delay in approving the new generation of cancer drugs - which are almost certain to be approved - undermines that respect. So, too, for example, does Nice's refusal to publish the computer model used to assess the cost-effectiveness of drugs to treat Alzheimer's disease.

It may be objected that we are arguing for clinical priorities to be set by public sentimentality and media sensation. And it is certainly the case that breast cancer - and Herceptin - attracts more attention than the bowel cancer that killed Tamar or the Avastin that could have helped her. Yet the answer to that is more information and more openness, not less. The development of a new generation of expensive anti-cancer drugs requires the NHS to make some difficult trade-offs. But the public support needed to make those trade-offs can only be obtained by facing them explicitly and openly.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Recruitment Genius: Senior Digital Marketing Consultant

£28000 - £45000 per annum: Recruitment Genius: A Senior Digital Marketing Cons...

Recruitment Genius: Assistant Stores Keeper

£16640 - £18500 per annum: Recruitment Genius: An Assistant Stores Keeper is r...

Recruitment Genius: Claims Administrator

£16000 - £18500 per annum: Recruitment Genius: This is an excellent opportunit...

Recruitment Genius: Software Developer - C# / ASP.NET / SQL

£17000 - £30000 per annum: Recruitment Genius: Developer required to join a bu...

Day In a Page

Read Next
Ed Miliband, Nick Clegg and David Cameron appeal to the audience during the Question Time special  

General election 2015: Not voting makes you responsible for the worst that follows

Yasmin Alibhai Brown
Prince William and his wife Catherine, Duchess of Cambridge show their newly-born daughter, their second child, to the media outside the Lindo Wing at St Mary's Hospital in central London, on 2 May 2015.  

The Only Way is Ethics: The birth of a royal baby will not top the news for long

Will Gore
'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

Bread from heaven

Dutch survivors thank RAF for World War II drop that saved millions
Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

How 'the Axe' helped Labour

UK will be 'run for the wealthy and powerful' if Tories retain power
Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

The price to be paid for challenging the rule of extremists

A revolution now 'consuming its own children'
Welcome to the world of Megagames

Welcome to the world of Megagames

300 players take part in Watch the Skies! board game in London
'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

Charlotte Gainsbourg on 'Nymphomaniac'

Starring in one of the most explicit films ever
Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

Robert Fisk in Abu Dhabi

The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

Vince Cable exclusive interview

Charging fees for employment tribunals was 'a very bad move'
Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

Iwan Rheon is returning to his Welsh roots

Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
Russell Brand's interview with Ed Miliband has got everyone talking about The Trews

Everyone is talking about The Trews

Russell Brand's 'true news' videos attract millions of viewers. But today's 'Milibrand' interview introduced his resolutely amateurish style to a whole new crowd
Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

It's time for my close-up

Meet the man who films great whites for a living
Increasing numbers of homeless people in America keep their mobile phones on the streets

Homeless people keep mobile phones

A homeless person with a smartphone is a common sight in the US. And that's creating a network where the 'hobo' community can share information - and fight stigma - like never before
'Queer saint' Peter Watson left his mark on British culture by bankrolling artworld giants

'Queer saint' who bankrolled artworld giants

British culture owes a huge debt to Peter Watson, says Michael Prodger
Pushkin Prizes: Unusual exchange programme aims to bring countries together through culture

Pushkin Prizes brings countries together

Ten Scottish schoolchildren and their Russian peers attended a creative writing workshop in the Highlands this week
14 best kids' hoodies

14 best kids' hoodies

Don't get caught out by that wind on the beach. Zip them up in a lightweight top to see them through summer to autumn
Robert Fisk in Abu Dhabi: The acceptable face of the Emirates

The acceptable face of the Emirates

Has Abu Dhabi found a way to blend petrodollars with principles, asks Robert Fisk