DR RICHARD TAYLOR FRCP MP
HOUSE OF COMMONS
LONDON SW1A 0AA

9 August 2008

Dear Sir

Jeremy Laurance dismisses health care rationing as having been tried in the NHS a couple of decades ago and the elimination of some cosmetic or unproven treatments as leading to imperceptible savings ("Can it ever be right for the NHS to reject drugs that could extend life?" 8 August).

Having worked in the NHS from 1959 to 1995 and been closely associated with it ever since, I have no recollection of any active attempts at rationing of health care other than by long waiting lists and more recently by the National Institute for Health and Clinical Excellence (NICE) whose work is internationally respected but which inevitably hits the wrong people, those with severe illnesses for whom new but expensive treatments offer benefit.

The Government appears to be unwilling to sanction discussion on rationing. A debate I instigated in the House of Commons on 3 December 2007 (Hansard cols.653-659) on health care rationing had its title changed, without my consent, to health care prioritisation – perhaps a less emotive word as it does not imply the withdrawal of funding for some treatments.

In this debate I outlined the irrefutable reasons for an open, public debate on health care rationing and the potential for savings to which this would lead. Even enforcing effectively the Government's own paper "Better Care Better Value Indicators" would lead to a saving of £2 billion. This alone would surely be enough to raise NICE's threshold for affordability to allow provision of some of the new drugs at the moment being turned down to the devastating disappointment of so many people including two of my own constituents.

Yours faithfully

Richard T Taylor

Independent MP for Wyre Forest.

The Editor, The Independent via e-mail to letters@independent.co.uk

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DR RICHARD TAYLOR MP
HOUSE OF COMMONS
LONDON SW1A 0AA

 

7 August 2008

Dear Sir

The decision to reject state funding for four anti-cancer drugs by the National Institute for Health and Clinical Excellence (Kidney cancer drugs judged too costly for 3,000 NHS patients, August 7) has been greeted with understandable dismay but misplaced opprobrium.

Nice is the government's only attempt at healthcare rationing and has won international praise for its work. Unfortunately, through no fault of Nice, this rationing may hit entirely the wrong people, those with very severe illnesses for whom new but expensive treatments offer benefit.

The government appears to be unwilling to allow a public debate about wider health care rationing. Surely most people would agree if certain treatments of marginal or cosmetic benefit were removed from state funding. Surely clinicians would agree that where evidence-based protocols exist for the best (and cheapest) treatment regimes for specific conditions they should be followed without feeling that their clinical freedom is under attack.

By effective, evidence-based, publicly supported healthcare rationing state funds could be liberated to enable Nice to raise its cost effectiveness threshold and thus allow NHS patients to have access to drugs like sunitinib that have been denied to two of my constituents recently.

Yours faithfully

Richard T Taylor

Independent MP for Wyre Forest.

The Editor, The Guardian by e-mail to letters@guardian.co.uk

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