Tuesday 9 February 2016

Following England

Ever since the UK Government introduced the cancer drugs fund for England, the Tories in Wales have been banging on about the need for Wales to follow suit.  I’ve always had my doubts about the question – if the underlying problem is that the NHS does not have adequate funding to be using new and innovative drugs, then the answer is to provide more funding, not for politicians to start over-riding clinical decisions by diverting resources from one type of treatment or disease to another.  It’s a gimmick – a populist one, to be sure amongst those who see family and friends suffering from the disease – but a gimmick nevertheless.
Last week, a House of Commons committee reported on the way that the fund is working in England.  The report covers a lot of detail, but crucially it says that there is no evidence that the fund is benefiting patients, extending lives or a good use of taxpayers' money.  I suspect that the first two parts of that conclusion are a little harsh; I’m sure that some of the individual patients and families would argue that they have benefited, and would oppose any move to wind up the fund. 
But any true assessment of the efficacy of the approach has to look not just at those patients and families who do see some benefit but at all of them – including those with other diseases and illnesses who may be losing out; the report specifically notes that extra cash has had to be diverted from elsewhere in the NHS to pay for the fund.  In the round, it’s clear that whatever the political advantages of establishing the fund, in medical terms it hasn’t proved to be quite as brilliant an idea as it was painted. 

I don’t expect the Tories in Wales to stop demanding that Wales follows England on this; following England is their natural default position.  I’m sure that, like the UK Government, they’ll claim that it’s just about changing the way the fund works and is administered.  Hopefully, the Welsh Government will continue to resist such calls and leave the decisions on medical priorities to those who know better than politicians.

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