Debate on NHS funds
The uncertainty that surrounded the High Court's judgment on the decision by Nice to restrict access to new Alzheimer's drugs is symptomatic of the wider confusion that exists over the way priorities are set for NHS funding.
Although those campaigning for more patients to receive Aricept, Reminyl and Exelon initially greeted the judgment as a major breakthrough, they were soon having second thoughts. There will, after all, be no immediate access for those in the early stages of dementia, one of the campaigners' key demands.
The National Institute for Clinical Excellence was created to bring an end to the postcode lotteries where patients in one part of the country were denied treatment that was available elsewhere. Nice has enjoyed a degree of success, but the system has given rise to problems of its own.
That there were sufficient grounds for the drug companies and the Alzheimer's Society to even take their case to the High Court demonstrates that Nice's decision-making procedures are not as open and accountable as they should be.
However, the row over access to Alzheimer's drugs is part of a much wider issue that will have to be faced sooner or later. As the population ages and scientific advances produce new and often more expensive treatments, the burden on the NHS grows. Nice is being forced to make increasingly nuance judgements as it tries to balance the NHS's historic commitment to universal healthcare and the reality of a health service budget that has finite limits.
This balancing act cannot continue forever. Ultimately, a review of what the NHS should be expected to provide may be the only way forward. The health service debate at the next election may not be about waiting lists but whether it can continue to be a universal service.
William Davis, Hall Street East, Wednesbury.
