Forum Topic

N.I.C.E.?

Good Luck to the Alzheimer's Society and all the relatives of sufferers who are appealing in the High Court against NICE's crackpot and unfair decision not to prescribe drugs that are proven to work and slow the decline of this cruel disease. All to save £2.50 a day per patient, this is a mean and spiteful thing to do, especially when so much money is wasted paying managers and consultants to interfere in the running of the N.H.S. If the powers that be had to look after all the people suffering from dementia and associated diseases they'd soon know how cheap prescribing the drugs is as against residential care. Instead because this is all left to 'carers' who of course are free of charge they couldn't care less. It is a bloody disgrace.

Vanessa Smith ● 7074d55 Comments

I would take some of the criticisms of NICE with a pinch of salt. The drugs companies brief the press very heavily on matters like this trying to get their drugs adopted more widely. NICE make their decisions primarily on a clinical not financial basis. If it is the same drug you are referring to that I read about they decided only to proscribe after the Alzheimers had advanced to a certain stage as there was no evidence of it being effective earlier than that. Even where it did show some effects the benefits were not enormous. NICE do a difficult job and are in the position of having to make some hard choices. There isn't an unlimited pot of money for medical care and somebody has to decide how it is divided. There is no real evidence that they don't do their job professionally and with integrity.

Dan Evans ● 7074d

We'll see - as someone who has had experience of looking after someone with dementia, anything that helps is to be welcomed.. I'm sorry but I don't buy the fact that this isn't all financially motivated

Vanessa Smith ● 7074d

Dan"There isn't an unlimited pot of money for medical care and somebody has to decide how it is divided".Are you really sure about this? The way we give out our free services to people who have contributed nothing to the economy, it would appear that we do have an unlimited pot of money! What about the enormous increase in administration staff, managers etc, thats where savings could be made?How long do you believe this country can sustain this system of allowing free access for health care to all and sundry who arrive here. You also stated that the the effects on the Alzheimers were not enormous, don't you believe that for £2.50 per day that it costs it is worth it even for a small improvement? This same Quango (NICE) tried also to deny life prolonging drugs to wome with breast cancer, in spite of it being [prescribed] by oncologists. This decision Gareth was based on nothing else but cost!Like my opinion on Social Housing, the same applies to health care, accessing benefits etc, is that we look after ALL of those who have contributed to our economy, by way of taxes and National Insurance first. When we can give the elderly for example, free care when in need of residential accommodation, and without being FORCED to sell their homes to pay for it, it is then we should give some thought to others! But then you may be asked for higher contributions to the system, I think this is something you "luvvies" seem to overlook.I must say Gareth that you do come across as a compassionate, caring person. I do hope you will never have the need for life prolonging/preserving drugs in future!

Account suspended ● 7074d

Are you incapable of have a discussion without resorting to name-calling?The important point about NICE is that they are making clinical decisions. Obviously in a world of budgets they ultimately have to put a price on how much we can pay to save a life or alleviate the suffering of an ill person but if they say that the use of a certain drug is not justified it isn't because they are penny pinching bureaucrats but because having looked at the trials of the drugs they are taking a view on its effectiveness. Individual medical practitioners may disagree but they are unlikely to have looked at the trials in as much detail or have studied evidence for alternative treatements.To talk about £2.50 a day is a con usually practised by people who are putting up your tax or trying to sell you life insurance. Even if the figure is correct it translates into a cost of around a £1,000 per annum and there are likely to be 100,000s with early stage Alzheimers.I do have personal experience of caring for someone with this disease and would heartily support the funding of any treatment that made things easier for the sufferer and the carer. NICE assessed the drug over the three stages of the disease. When the first stage of the disease starts to manifest itself, for instance when the patient gets people's names mixed up, they found there was little benefit and therefore recommended it that it should not be given until the disease was more advanced.I can understand you will be cross that some of the money saved my be going towards the treatment of foreigners but this is hardly the fault of NICE.

Dan Evans ● 7074d

AndrewPlease bear in mind that there are also plenty of people who have contributed nothing to the economy and who have not as you have put it, just arrived here.

Gareth Evans ● 7074d

Gareth"Please bear in mind that there are also plenty of people who have contributed nothing to the economy and who have not as you have put it, just arrived here".Then that is all the more reason to stop it, we cannot do anything about our own apparently, but we can for all the others arriving here to take advantage of free health care ! Both you and Dan have conveniently omitted to comment on charges for the elderly in care, or how we are to sustain free health care and benefits for everybody forever......Are you prepared to pay extra NI and Tax for this, yes or no?

Account suspended ● 7074d

Are you incapable of have a discussion without resorting to name-calling?Name calling. Please explain,what name(s) have I called you? "I can understand you will be cross that some of the money saved my be going towards the treatment of foreigners but this is hardly the fault of NICE"."Cross" would not be the first word to come into my mind about treating foreigners, at the expense of our own peopleI think that the moderators would ban me, if I said what I really think! I do realise it's not the fault of NICE for this, it's of course the "luvvies" of the left who are to blame. 

Account suspended ● 7074d

AndrewPlease, get real. I have not conveniently omitted anything. I have simply pointed something out to you. Is that clear enough for you to understand? Yes or no?

Gareth Evans ● 7074d

Gareth, I think Andrew believes that if we don't actually say we are in favour of something then we must be against it.On the question as to whether I would pay more tax for care for the elderly, I'd rather not but increasingly this looks inevitable as the population ages. Luckily immigration means that there are lots of younger people joining the workforce to spread the tax burden. Without them then taxes would have to rise much further. They also make up a substantial proportion of the people involved in geriatric health care to the extent that the system would probably collapse without them.Also given the demands on the public purse for care for the elderly is likely to expand in the future, I am grateful that agencies like NICE are there to resist pressure from the large drugs companies for the adoption of expensive but not particularly effective new treatments.

Dan Evans ● 7073d

Dan I do enjoy a discussion with you even if I don't always agreee with you  - however, I think your last sentence is rather sweeping, a lot of relatives and carers of people with Alzheimer's state that these drugs DO make one hell of a difference,and if it lessens the burden on them too then I think they should be freely available, remember quite often the carer is as old as the person they are caring for, I saw my Mum struggle even though I did as much as I could, I wasn't there 24 hours a day, it is a killer and I'm sure contributed to her health declining. I'm afraid it's case of you pays your money you take your choice and I don't believe or trust N.I.C.E. - sorry.

Vanessa Smith ● 7073d

Dan"Gareth, I think Andrew believes that if we don't actually say we are in favour of something then we must be against it".By avoiding the issue, and concentrating only on part of it, what other conclusion could I come to."They also make up a substantial proportion of the people involved in geriatric health care to the extent that the system would probably collapse without them".That is because that the "powers that be", will not pay a living wage, and those that they do employ, are prepared to work for much less, those from eastern europe in particular, will not put up with this situation for too long, and when they eventually bring over their families, and have to face the reality of trying to make a life for themselves, buying a home etc. I think that is when problems will arise. Employing them just for cheap labour cannot be sustained nor should it.

Account suspended ● 7073d

"Luckily immigration means that there are lots of younger people joining the workforce to spread the tax burden."I do not believe immigration is as good for the economy as some would have us believe.  I am sceptical about the numbers here who are working, who are paying taxes & not sending their earnings back home.Additionally, the major flaw to the argument about immigration paying for our aging population is that immigration increases the population.  Who is going to look after this inflated population when they age?  Clearly, we cannot sustain continual immigration as a 'solution'."They also make up a substantial proportion of the people involved in geriatric health care to the extent that the system would probably collapse without them."Immigrants make up a substantial proportion of the people involved in health care in general, however, having been in hospital recently the overwhelming majority of patients were immigrants.

Lynn Clark ● 7073d

Dan"Gareth, I think Andrew believes that if we don't actually say we are in favour of something then we must be against it."Then why comment only on part of it, and ignore that which you can't/won't answer, surely that's not so difficult is it? I thought that the pair of you had answers for everything..........perhaps not it would appear!

Account suspended ● 7073d

Why would you suppose that we would have the answers Andrew when you think that you know absolutely everything and you can't acccept that others have a viewpoint?

Gareth Evans ● 7073d

Dan I'm relieved that he is not in a position of influence. Socio-economic policies under Andrew would be a nightmare scenario.I think that governments across the world should do a lot more on reducing the price of drugs but that's another matter. There are many people who suffer through not being able to access medicines and treatment so I agree with Vanessa on the points she has raised, especially in connection with NICE.

Gareth Evans ● 7073d

Your answer betrays a complete lack of understanding of the way the NHS works. A relatively small proportion of the jobs are unskilled and many of the people who come to work from other countries are highly trained professionals.

Dan Evans ● 7072d

Gareth, the specific case that Vanessa raised originally concerned an Alzheimer's drug that NICE have given approval for. However their guidelines state that it should only be given in the later stages of the disease. Concerned relatives of Alzheimer's patients in the early stages were outraged by this and they provided fuel for a Daily Mail campaign of vilification against NICE which some of the less scrupulous pharmaceutical companies stirred up by briefing against NICE. The drug in question did not prevent the onset of symptoms but only improved the condition of the patient once the disease had took hold therefore it was a complete waste of money to give it to sufferers in the primary stage. This decision was made by qualified people at NICE based on medical evidence.If you have a particular reason for doubting their integrity and trustworthiness it would be interesting to hear it, but please don't join a tabloid inspired lynch mob without looking into the facts. NICE are an easy target but having a consistent policy on drugs across the NHS is clearly a good thing and the line has to be drawn somewhere. I have read nothing that makes me doubt the professionalism of the people who make these difficult decisions.

Dan Evans ● 7072d

A small point Dan, I don't read the 'Daily Mail', - would I? And this is not the first time N.I.C.E. have done this sort of thing, at the back of my mind at least is the sneaky feeling that won't go away, that finances play a major part in N.I.C.E.'s decisions.

Vanessa Smith ● 7072d

Interesting discussion on this court case on 'This Morning' The Alzheimer's Society made some very good points - N.I.C.E. changed from their original view that these drugs WERE beneficial, they have not taken into account carer time and they have also based their residential care costs on approx. £369 per week, as if - in their dreams! N.I.C.E. are making the really pathetic excuse that this is not a cure - we all know that, but many diseases are held at bay by medication. A man diagnosed over 7 years ago was on and although hesitant looked and sounded good, if that is what it does for people when given early enough it is amazing. His wife also questioned why the N.H.S. can fund helping smokers give up when diseases linked to that are self inflicted, yet someone who is unfortunate to get something they have no control over has to be treated like this.

Vanessa Smith ● 7072d

Dan"The drug in question did not prevent the onset of symptoms but only improved the condition of the patient once the disease had took hold therefore it was a complete waste of money to give it to sufferers in the primary stage. This decision was made by qualified people at NICE based on medical evidence".Yes, and totally disregarded the views of the sufferers and their carers, after requesting them to do so!For you to put in print, that it was a "complete waste of money" shows and demonstrates what a caring compassionate soul you really are. Hope you never require a drug because of cost!

Account suspended ● 7072d

Dan Thanks. I'm not joining any lunch mob, my point was that I feel in general that the drug companies get away with far to much.

Gareth Evans ● 7072d

We have a strange one.  We were told a family member would be prescribed the drugs - there was no argument about it at all.  She would be referred to the Memory clinic and they would assess her then put her on the drugs for a trial few months to validate any improvement ....  many months later we are still waiting for the referral to the Memory clinic to go through!  This is in Epsom.As far as other prescriptions go in general, there must be a great deal of money wasted in the first prescription after a change in  medication.  Would it not make sense to allow a nominal charge for a 2 week prescription 'trial' when changing drugs then the rest of the medicine could be picked up for the remainder of the prescription charge, from the same chemist?  So often the drug doesn't agree or give the desired results and the rest of the 2 month supply has to be binned (I take ours back to the Chemist for burning).

Sarah Felstead ● 7072d

Andrew's response was so bizarre I can't really respond to it. If someone can translate for me I'd be very grateful. I'm also slightly at a loss about your point Gareth. Having some familiarity with the industry I would definitely concur that drugs companies need to be watched carefully - isn't that exactly what NICE's job is though? The big pharmas will be lobbying hard for new and more expensive treatments to be adopted. This will include targeting specific medical practitioners and pressure groups for particular illnesses. It is not surprising therefore that they can find people who will support their case. These issues are rarely clear cut. The pharmaceutical industry is not intrinsically unethical but profits are their main aim so they are likely to focus on the drugs that offer them the highest margin i.e. the non-generic ones. If an individual doctor has had success with a drug he is likely to support it but NICE can see the broader picture and will know if this is an isolated case. The point about the Alzheimer's drug was that it simply didn't work in the early stages.As for the questioning of the integrity and motivations of the people at NICE you and Vanessa may have greater specific knowledge than I am aware of but the arguments seem familiar from some of the unbalanced coverage in the tabloid media. All I can say is that my experience of people in general is that I can't really say I have ever met anyone so cynical that they would prevent the access of ill people to an effective treatment for some sort of marginal professional advancement. My experience of people who work in the health industry has been that they have a higher ethical standard than the population at large. They have after all chosen to dedicate their lives to helping others. It therefore seems inconceivable to me that the staff of NICE could possibly as unscrupulous and amoral as you seem to think they are. My natural instinct is to trust the medical profession and every time I hear a spokesperson for NICE I find their responses to criticism reasonable and convincing. Maybe I am naive and your cynicism is justified.

Dan Evans ● 7071d

"My natural instinct is to trust the medical profession..."I agree, but regrettably money does play a great part in the decision making process (& I have two personal experiences to back this up).I know nothing about NICE so cannot possibly comment about them specifically, but I no longer unquestioningly trust the medical profession.  It may well be that "people who work in the health industry has been that they have a higher ethical standard than the population at large", but these are not necessarily the people making the financial decisions.  And I certainly don't trust the Government with healthcare!

Lynn Clark ● 7071d

The drug in question did not prevent the onset of symptoms but only improved the condition of the patient once the disease had took hold therefore it was a complete waste of money to give it to sufferers in the primary stage. This decision was made by qualified people at NICE based on medical evidence".Yes, and totally disregarded the views of the sufferers and their carers, after requesting them to do so!I thought that this was quite clear, in other words they (NICE) refused to hear what the sufferers (ALZHEIMERS) and carers had to say, even when they had asked them to do so. Was their opinions perspective that irrelevant? What about the medics who also submitted their favourable evidence?For you to put in print, that it was a "complete waste of money" shows and demonstrates what a caring compassionate soul you really are. Hope you never require a drug because of cost!The last point above, does I admit, need clarification, so here goes; I hope you never need a life prolonging/preserving drug in future, and you are refused it on the grounds of its' cost not on it's benefit! Do you agree with NICE that it was "a waste of time" prescribing it in its' early stages?Additionally, I understand that it is prescribed in Scotland,as is Herceptin, perhaps they know something that NICE doesn't.Wasn't it this compassionate organisation also, who refused Herceptin to women with breast cancer, and finally gave in after High court action. The lady concerned has I understand blossomed and her health has greatly improved since it was prescribed, strange that don't you think?

Account suspended ● 7071d

Rang the Consultant Psychiatrist today - and without any hesitation he spoke to me, which is very supportive.  He is going to send the prescription promised, straight away.

Sarah Felstead ● 7071d

Good to hear Sarah, well done.

Gareth Evans ● 7070d

I'm relieved that he is not in a position of influence. Socio-economic policies under Andrew would be a nightmare scenario.As opposed to you two "luvvies", who would be willing to deny particular drugs to patients, put our people (ALL) at the back of the queue, for almost everything, and continue with an open door policy to all and sundry who decide to turn up on our shores. Do you think the PC brigade have done anything to enhance our lives here? Just take a look around you, there is mayhem on our streets, with youngsters killing each other, the police unable to intervene in demonstrations (unless it's us of course!) Drugs, paedophiles, and now we are letting prisoners out early. The elderly scared to go out at night, and some don't even feel safe in their own homes. Yes you lot have a lot to answer for I'm afraid

Account suspended ● 7070d

CRAWLER!!!!

Account suspended ● 7070d

Who is the crawler, Andrew?  ;-)

Sarah Felstead ● 7070d

GARETH.......He who is the fount of all knowledge!

Account suspended ● 7070d

I am perplexed - why is he a crawler, might I ask?

Sarah Felstead ● 7070d

It was meant to be a "lighthearted joke" Sarah perhaps on reflection uncalled for. Obviously you did not see it in that vein, if you or Gareth were/are offended accept my apology!I think though, that I may have to keep my opinions to myself in future, and not put them in print on any forums, shame that this is what this country has descended into!

Account suspended ● 7070d

Crumbs! Andrew! don't take it like that! I just didn't understand what I took to be a sociable posting to be anything else and wondered if I was missing something - carry on, please!As far as identifying yourself in court (and in many situations such as driving tests) there is no question about it.  The insult of somebody appearing before a Magistrate administering our hard won and fought for Community laws should take precedence.

Sarah Felstead ● 7070d

Andrew Typical of you to go in for name calling. Can't get your own way on something so you resort to name calling. You should learn that name calling never gets anyone anywhere.

Gareth Evans ● 7070d

Personal abuse now Andrew. How clever of you.

Gareth Evans ● 7070d

AndrewAgain, if you can't get your own way you name call. Typical I would say of you but I'll let others judge for themselves as to the type of person you are.

Gareth Evans ● 7070d

"GARETH.......He who is the fount of all knowledge!" What, and displace you from being the man who knows it all Andrew!! Never.

Gareth Evans ● 7070d

GarethYou certaily are a sensitive young man. Just what names did I call you, that you want others to make a judgement on? Was it "Luvvy", put me out of my frustration perleeze?

Account suspended ● 7070d

AndrewI'm sure that scrolling up the page and checking your postings won't tax you too highly. Please try scrolling up, reading your postings and considering your question again.

Gareth Evans ● 7070d

I'm a sensitive young man by your account Andrew. Well in that case, I'm delighted to be considered the exact opposite of yourself.

Gareth Evans ● 7070d

GARETH.......He who is the fount of all knowledge!" What, and displace you from being the man who knows it all Andrew!! Never.I'm sure you would if you really had the ability Gareth, perhaps in a few years time eh?

Account suspended ● 7070d

AndrewHardly, In your case the years seems to have had a marked effect on your powers of rationale and reason.

Gareth Evans ● 7069d

Desperately sad news that the courts found in favour of N.I.C.E. on the drug for Alzheimer patients, but then I always thought many of the judiciary weren't in posession of a full set of marbles, I hope that Judge watched the programme on Alzheimer's the other night she would then know how devastating this disease can be. Recently N.I.C.E. refused to allow a drug for Rheumatoid Arthritis to be prescribed on cost grounds and one doctor said they were really stupid and not looking at the bigger picture. This drug made such a difference that sufferers were able to go to work, this not only meant that other drugs weren't needed it also meant a saving in benefits when people were in too much pain to be able to earn a living. Talk about penny wise- pound foolish, since when did number crunchers know better than the medical profession?

Vanessa Smith ● 7028d

Vanessa"Desperately sad news that the courts found in favour of N.I.C.E. on the drug for Alzheimer patients, but then I always thought many of the judiciary weren't in posession of a full set of marbles, I hope that Judge watched the programme on Alzheimer's the other night she would then know how devastating this disease can be".I agree entirely with all you have said, I watched this programme, and I have nothing but admiration for the lady who looked after this poor man, watching him gradually deteriorate. The support she had from the Health service was in my opinion criminal. She deserves a medal for her devotion to him (I'm sure she would disagree) because her love for him shone through. The money she has saved the Health service, in caring for him is, and must be incalculable, yet they penny pinch for a drug that costs "peanuts", although not a life saver, gives the victim (patient)some degree of dignity. Gordon Brown can find millions, if not billions for aid to the rest of the world, but cannot spare any for those suffering pain and trauma here. As a footnote, correct me if I'm wrong (I'm sure someone will) I haven't witnessed a stampede to help the homeless flood victims, from anywhere, but then again there ours aren' they?) British compassion at it's best?

Account suspended ● 7027d

Dan"The important point about NICE is that they are making clinical decisions. Obviously in a world of budgets they ultimately have to put a price on how much we can pay to save a life or alleviate the suffering of an ill person but if they say that the use of a certain drug is not justified it isn't because they are penny pinching bureaucrats but because having looked at the trials of the drugs they are taking a view on its effectiveness. Individual medical practitioners may disagree but they are unlikely to have looked at the trials in as much detail or have studied evidence for alternative treatements".Did you watch the moving documentary about the poor man with Alzheimers? If you did, would you still be of the same opinion. And yes! they are "penny pinching", and have robbed him of any dignity. "Even if the figure is correct it translates into a cost of around a £1,000 per annum and there are likely to be 100,000s with early stage Alzheimers".So even on your estimate, it would only cost £1,000.000, the price of a missile, manufactured to kill, small price don't you think for giving dignity to people who have contributed all of their lives to this country's economy!

Account suspended ● 7027d

Two interesting snippets in the news in the last week, £82m paid out by Health Trusts to managers no longer needed by way of compensation, since further re-organisations. Today a report that 'health tourism' is costing us, the taxpayer, £30 odd millions because trusts don't follow guidelines and charge non-residents for the services they use, the total was in excess of £60m. Question first of all - Why not? Then second, how many drugs would that pay for for Alzheimers sufferers? Third - if N.I.C.E. is the National Institute for Clinical Excellence, why have they not berated the trusts who have failed to charge people who have no right to free health care here - not very excellent really is it? All those managers and none of them apparently could add up, frightening.

Vanessa Smith ● 7003d

Today a report that 'health tourism' is costing us, the taxpayer, £30 odd millions because trusts don't follow guidelines and charge non-residents for the services they use, the total was in excess of £60m. Question first of all - Why not? Then second, how many drugs would that pay for for Alzheimers sufferers? Third - if N.I.C.E. is the National Institute for Clinical Excellence, why have they not berated the trusts who have failed to charge people who have no right to free health care here - not very excellent really is it? All those managers and none of them apparently could add up, frightening.VanessaIn answer to the first part of your question,IMO they are scared of the PC brigade, and their continual obsession of seeing everything as a "race issue" You may have noticed that there are several on this site! I know that some other countries have reciprocal treatment agreements with the UK, but I am sure they would not tolerate the situation that we have. I have asked many times just how long we can sustain this abuse, apparently when asked to pay at the end of any treatment, all they need to do is say "I don't have any money", and we the mugs as usual can do sod all about it. Try pulling that one in the States!

Account suspended ● 7003d

We would NEVER dream of travelling abroad without travel insurance and I suspect most people are the same - France has just decided to get tough with British ex-pats and withdraw their medical treatment entitlement - so they are all facing huge bills if they should fall ill- and that's an E.U. country. We really must be a soft touch. Tonight on the news a lovely young man who came here with his Aunt from Nigeria at 11 years of age is under threat of deportation, he has excelled at school - gaining a place at Cambridge and he has also done a lot of work for black youngsters and the Home Office are getting all snotty about letting him stay, so we let murderers stay here even though they are Italian by birth because of their 'human rights', yet someone who is an asset and a credit to this country we want to deport! We have to assume the lunatics have finally taken over the asylum.

Vanessa Smith ● 7003d

"We have to assume the lunatics have finally taken over the asylum".The lunatics at the Home Office have been doing this for years, along with the lunatic judges, lawyers, and MP's. The trouble is, that we are unable to change anything, but still have to stump up for tax and insurance. I also saw the black lad, and agree that he would be somebody that other black youngsters would look up to, but I bet that it hasn't even occurred to them! Where is Cherie when she's needed?

Account suspended ● 7003d

DanYou were right to say I was cross, (to put it mildly!) what is your take on what Vanessa has quoted?You said:-“I can understand you will be cross that some of the money saved may be going towards the treatment of foreigners but this is hardly the fault of NICE”. Vanessa has a point though don’t you agree, particularly:-“Third - if N.I.C.E. is the National Institute for Clinical Excellence, why have they not berated the trusts who have failed to charge people who have no right to free health care here - not very excellent really is it?” In excess of £60 million! How many drugs would that buy, for those who had actually paid their NI contributions?”.

Account suspended ● 7001d

"if N.I.C.E. is the National Institute for Clinical Excellence, why have they not berated the trusts who have failed to charge people who have no right to free health care here"There is a clue in the organisation's title. The charging of overseas patients is an adminstrative not a clinical matter.As for the general point it is easy to play these numbers games with the NHS budget because it is so massive. The reality is that management and administrative costs as a percentage of total in the organisation are way below those seen in the private sector. Clincal staff have always complained about over-management but many of the NHS's current problems stem from a having too thin a layer of management control and too many budgetary decisions being taken by doctors who inevitably over-funded their own specialisations to the detriment of others.Health Trusts are all conscious about so-called health tourism but the numbers quoted probably significantly overstate the true cost. Many of the people treated probably were entitled to free treatment but it wasn't possible at the time to verify their status. The Trust manager has to take a view on the control of this problem but £30,000,000 only represents a handful of patients per hospital or unit. Employing someone to verify status before treatment at each trust would probably cost more than the money lost and the likelihood is that in most cases there would be no way the patient could pay what is owed.Also if there was more onus on Trusts to check on overseas patients before treating them inevitably some people would die due to lack of care. This would mean that British travellers would receive a less sympathetic response in other countries and reciprocal arrangements would become unworkable.NHS managers work all the time to tackle waste and fraud in the system but it can never be entirely eradicated so there isn't a pot of money waiting to be spent on Alzheimers drugs. Also as has been pointed out earlier in this thread there was a strong clinical argument for restricting the use of the Alzheimers in the way that NICE did.

Dan Evans ● 6998d

Many of the people treated probably were entitled to free treatment but it wasn't possible at the time to verify their status. The Trust manager has to take a view on the control of this problem but £30,000,000 only represents a handful of patients per hospital or unit. Employing someone to verify status before treatment at each trust would probably cost more than the money lost and the likelihood is that in most cases there would be no way the patient could pay what is owed.Try telling the Yanks that one. As regards the £30,000,000 would that have not bought drugs for Breast Cancer sufferers and Those unfortunates with Alzheimers....your'e all heart Dan! So your message seems to be "come on in we will pay for youyr care, sod those who have actually paid in to it, get to the back of the queue!

Account suspended ● 6998d

Dan - I'm sure that the Alzheimers patients and their families will be delighted to hear this 'strong clinical argument', as far as I'm concerned there could never be one. N.I.C.E.  - if being asked to make life and death decisions surely aren't dumb are they? If I was part of a body restricting drug treatments on the grounds of cost - and that's what it is no matter which way you cut it - and I saw all this money going on compensation payments to managers and 'health tourists', I don't think I'd be inclined to keep quiet, And the clue is not in their title - 'excellence' doesn't even come into it, shameful just about might. After all they're taking our money while we're working and they don't tell you that come the day you might actually need something you won't be able to have it.

Vanessa Smith ● 6998d

Interesting snippet about N.I.C.E. the outfit for 'clinical excellence', they have just published guidance on the prevention of ventilator-assisted pneumonia. "Oral antiseptics (for example 2 percent chlorhexidine) should be included as part of the oral hygiene regimen for all patients who are intubated and receiving mechanical ventilation". The strongest available chlorhexidine mouthwash is 0.2 percent. As 'Private Eye' notes- if N.I.C.E. AND also the National Patient Safety Agency can both make the same tenfold error, we're all stuffed!

Vanessa Smith ● 6977d