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"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 ● 6473d

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 ● 6546d

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 ● 6546d

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 ● 6549d

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 ● 6549d