Tuesday, August 29, 2006

ANOTHER LIFESAVING DRUG DENIED TO NHS PATIENTS

Three women who met as cancer patients are planning a joint legal action to win access to Velcade, a drug for treating multiple myeloma. The "Velcade Three" - Jacky Pickles, Janice Wrigglesworth and Marie Morton, from Keighley in West Yorkshire - are among hundreds who will be denied access to the drug if the National Institute for Health and Clinical Excellence (NICE) sticks to its ruling that it is not cost-effective. Velcade is the first new treatment for multiple myeloma in more than ten years and has been licensed for more than two years for patients who have relapsed.

The drug is available in Scotland, Wales and Northern Ireland and throughout the rest of Europe. Health insurers such as BUPA and PPP pay for it because they believe that it is effective. But primary care trusts in England take their cue from NICE, whose appraisal committee will hold its final meeting next week. Its consultation document, published last month, shocked specialists in the disease.

The International Myeloma Foundation said that the ruling was "ill-informed, unjust and unfair". Eric Low, the chief executive of the British branch, said at the time: "This is an extremely disappointing decision that has sent shockwaves through the myeloma community. Failure to have this preliminary recommendation overturned would represent a catastrophic blow."

Mrs Pickles, 44, said yesterday: "We're waiting for the final guidance from NICE. Hopefully it will change its mind. But if it doesn't, we're going to look to legal action. "We're going to go as far as we can, for each other's lives and for every other myeloma sufferer. Velcade is the best thing for myeloma for four decades. Mrs Pickles, a midwifery sister at Bradford Royal Infirmary, had the disease diagnosed five years ago and has undergone chemotherapy, a bone marrow transplant and a course of thalidomide, the drug that caused birth defects in the 1960s but which has been reborn as a myeloma treatment. All worked for a while before her condition worsened again. Last October she was put on a trial of Velcade, which costs 18,000 pounds for the full eight cycles, and was restored to normal. "That trial did well for me, but I could need the drug again at a later stage," she said. She met Mrs Wrigglesworth, 59, and Mrs Morton, 57, while having treatment and they are giving each other support. "We're in this together," Mrs Pickles said.

The NICE analysis found that the claims made by the drug's manufacturer, Janssen-Cilag Ltd, were not justified by the evidence. One trial showed a 41 per cent reduced risk of death in the first year of treatment. But the NICE view was that the benefits did not meet criteria set for NHS prescription.

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Now it's a radiology scandal in Queensland public hospitals

Peter Beattie's major health promise of the election campaign - a new $700 million children's hospital - has been marred by a fresh scandal affecting thousands of patients. Mr Beattie yesterday said a re-elected Labor Government would build a new 400-bed children's hospital next to the existing Mater Children's, with most of the services now offered by the Royal Children's Hospital to move to the new facility from 2011.

But the announcement has been overshadowed by news that a prominent doctor who starred in Government advertising on plans to fix Queensland's ailing health system has now turned whistleblower, exposing deep flaws in the state's radiology services. Royal Australian College of Radiologists president Liz Kenny has revealed thousands of X-rays, ultrasounds, MRI and CT scans ordered for public hospital patients are never seen or assessed by a radiologist. Dr Kenny, who works for Queensland Health, has told The Courier-Mail that critical radiology workforce shortages mean thousands of X-ray results are only seen by GPs, most of whom are untrained at assessing and diagnosing the results. The situation means patients are at risk of having conditions, such as cancers, tumours or fractures left undiagnosed.

The revelations about the state of the hospital system threatens to derail Labor's so-far trouble-free election campaign. Coalition health spokesman Bruce Flegg said the situation was putting lives at risk. "With these sorts of numbers going through you are going to miss things that cost people their lives," he said.

Health Minister Stephen Robertson said there was an international shortage of specialists, especially radiologists. "But through the $1 billion worth of salary improvements, Queensland is now competitive in the recruitment market for radiologists and Queensland Health is working to fill vacant positions," he said.

Dr Kenny said about 500,000 scans were "unreported" at any one time and the extent of those never seen by radiologists only became evident in the past three months. "The magnitude of what is unreported is staggering." Dr Kenny said patients whose scans are not seen by a radiologist did not benefit from their expertise. "It leaves a substantial hole in the management of the patients," she said. Official hospital figures obtained by the Coalition reveal the problem is widespread in both urban and regional areas.

Toowoomba Hospital is the worst in the state with 80 per cent of x-rays and other scans never reported on by a radiologist. Other hospitals which have significant numbers of unreported scans include Gold Coast (56 per cent), Hervey Bay (66 per cent), Royal Brisbane Womans Hospital (49 per cent), Townsville (35 per cent) and Warwick (50 per cent).

A recent survey of 270 Queensland Health radiographers also found 63 per cent plan to resign within six months, a move likely to cause a blowout in waiting times for routine X-rays by Christmas. "With the staffing levels already under pressure, this reduction in professional numbers will result in significant cutbacks in all services, such as x-rays, breast screening and diagnostic imaging for cancer at the majority of Queensland public hospitals," he said. One radiographer said: "We just don't have the people to help all those trapped on the waiting lists."

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

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