LETTER : Difficult choices over MS drug

Sir: Polly Toynbee's article (11 March) gives the impression that Nottingham health authority's decisions relating to the use of beta- interferon are purely motivated by the need to cut costs. The reality is more complex.

We consulted the local MS groups, GPs, consultants, the community health council, the medical advisory committee and the drug company itself. We also took account of the results of the drug over the five-year trials. After giving full consideration to these views, we decided to put extra funding into the local neurological services in the next year. This will enable more effective treatments to be made available to patients.

Your contention that our public consultation meeting was in some way our response to a "row", that it was to explain why patients couldn't have the drug and that it was only as a result that the health authority found "extra money" is inaccurate. The public meeting was planned to take place following the issue of guidance by the Government. No decision had been taken before the meeting and the meeting directly informed our decision. This was always the planned sequence of events.

There will never be sufficient funds to meet all demands. But we shared these facts in public debate to gain the perspectives of the community and support the clinicians who face the hard decision of selecting the most appropriate patients.

Dr Julie Woodin

Chief Executive

Nottingham Health Authority

David Edwards

Chief Executive

Queen's Medical Centre,

University Hospital NHS Trust