The government has given up on evidence based policy making. We’re now firmly in the land of fairy tales.It’s a staggering admission of guilt. It’s like having a public argument with the murder victim hours before they find the body.

The government has given up on the need for scientific advice before classifying drugs.

Last week’s police reform and social responsibility bill contains a clause scrapping the requirement for the home secretary to appoint at least six scientists to the Advisory Council on the Misuse of Drugs (ACMD). So that’s that then. They’ve admitted it.

The drugs war has nothing to do with reality. It is now to be based entirely on fairy tales.

The mask has been slipping for a long time. When Jacqui Smith agreed, under Gordon Brown’s orders, to reclassify cannabis as class B, undoing one of the only genuinely liberal acts permitted under the Blair regime, she did so with a ferocious disregard for fact.

Cannabis use was falling and had been since decriminalisation. She did it anyway. For those of us who still value the idea that we might adopt a position on the basis of empirical data, this was practically a self-contained manifesto. It couldn’t have been clearer. Facts were no longer relevant to policy.

But the crux came a little later, when Professor David Nutt was sacked as the chair of the ACMD for suggesting that taking ecstasy was no more dangerous than riding a horse.

This is merely a statistical fact. Nothing more. It is not an offence, or a witticism, or an argument. It is a statistical fact.

It is understood by tens of thousands of young people in the UK every Saturday night, young people who now appreciate the gulf between what the government says about the world and what the world is really like. They might act stupid when they dance, but at least they’re smart enough to realise that the country’s leaders are the ones divorced from reality.

When Alan Johnson sacked Nutt, he was praised across the Commons. “Scientists should be on tap, not on top,” he was told, borrowing an old Churchillian phrase. I like Churchill too, but I’m always rather put off by people who think that quoting the man automatically wins an argument.

MPs have a tendency to get rather hot under the collar with this stuff. They are the elected representatives – they don’t like it when anyone gets superior around them. Their reaction to the ACMD was equivalent to their reaction to the Phil Woolas judgement. On the ACMD they didn’t like a scientist appearing to overrule the home secretary. On the Woolas case, they didn’t like judges appearing to overrule the election of the MP by his constituents.

The only way either one of these arguments holds is if you discount the role of truth in politics. The people of Oldham East and Saddleworth are entitled to accurate information upon which to base their decision at election time. Without it, they cannot make a valid decision.

The home secretary can only make drug policy on the basis of statistical and medical facts. Without it, we’re in the woods without a compass.

Plainly we must be vigilant against any threat to the authority of our elected representatives, such as the presidential administration of Tony Blair and the gradual decline of parliament as a check on the executive.

But without an assurance that our representatives make decisions based on accurate information, their role is without meaning. We might as well blindfold them, spin them round, and get them to pin a policy on the back of a donkey.

The truth is, the ACMD’s scientific requirement is being removed to prolong a drug war which has now been invalidated on every conceivable level – politically, strategically, morally and logically. Drug policy is based on tabloid headlines, not truth – or even a genuine concern for the young people of Britain.

If the Home Office cared at all about young people it probably wouldn’t have reclassified cannabis when its own data showed that decriminalisation had reduced use. If the Home Office cared about young people it would be honest about the relative dangers of drugs such as ecstasy, which tens of thousands take regularly without harm, so that they listen when they receive warnings about genuinely dangerous drugs, like crack cocaine.

A great deal has changed in Westminster over the last few months – but not this. Science is still considered a humiliating distraction by the British government.

Anyone old-fashioned enough to still abide by the ideals of the enlightenment should feel let down – but not surprised.

By Ian Dunt at http://www.politics.co.uk/-the-day-westminster-gave-up-on-science

Health Direct is amazed that this government has abdicated it’s responsibilities on drugs as one of David Cameron’s first speeches as an MP in the House of Commons was to highlight the chronic waste of police time pursuing  illogical and flawed drugs enforcement policies.

The Amercians have a phrase for their version of NICE- the death panel. Now at last the National Institute for Curbing Expenditure (NICE) is to lose its power to decide which drugs are too expensive. The government’s drug rationing body, Nice, is to be stripped of its power to turn down new medicines for use in the NHS, ending emotive battles with patient groups but raising the spectre of a postcode lottery for care.

The health secretary, Andrew Lansley, believes that Nice should continue to write guidelines for doctors on the best treatments for their patients, but the Guardian understands he will remove its controversial power to ban the use of drugs it considers too expensive for the benefit they offer.

The move will be greeted with enthusiasm by the pharmaceutical industry, which has opposed Nice from the outset, and by certain patient groups, set up to lobby on specific diseases, sometimes with pharma funding, that have joined cause with them in angry denunciations of Nice when drugs found to have limited benefit have been rejected.

But the decision is likely to cause consternation among the supporters of Nice, who warn of a return to the “postcode lottery” days before Nice came into being, when some patients could get the drugs they wanted on the NHS but others could not.

Critics also point out that careful scrutiny of the cost-effectiveness of drugs is essential to keep drug bills down and ensure that NHS money is not spent on medicines with very limited effect – to the detriment of other patients who may not get the care they need.

“Real growth in the NHS will be about 0.5% in the next few years,” said Alan Maynard, a health economist. “We’re going to have rationing. The question is whether we have it at a national level or let 150 primary care trusts or whatever do it their own way.”

David Cameron’s announcement of a £200m fund for new cancer drugs, made during the election, “drove a coach and horses through Nice”, said Maynard. He said he thought Nice was “under considerable assault”.

Lansley wants the decision on whether a patient should get a drug to be moved back to the patient’s doctor. The local commissioning body will be asked to agree to pay for it. The cost of the drug will be decided through a new “value-based pricing” system.

The NHS will negotiate with the manufacturer on a price for each new drug, taking into account not only how clinically effective it is and how it reduces the burden on the patient’s carers but also what other treatments are available and how “innovative” the company has been in producing the drug.

The health secretary told the Guardian that reforming the way medicines were paid for would help ensure money was spent wisely.

“We need a system that encourages the development of breakthrough drugs addressing areas of significant unmet need. And we need a much closer link between the price the NHS pays and the value that a new medicine delivers, sending a powerful signal about the areas that the pharmaceutical industry should target for development,” he said.

“Most importantly, using our cancer drugs fund in the interim, and value-based pricing for the longer-term, we will move to an NHS where patients will be confident that where their clinicians believe a particular drug is the right and most effective one for them, then the NHS will be able to provide it for them.”

The pharmaceutical and biotech industries have heavily lobbied governments for a long time, arguing that Nice is an obstacle to innovation, delaying the introduction of their new drugs into the NHS and sometimes turning them down or restricting the numbers of patients for whom they can be used. Under the new system, they will be able to argue for a premium price for a drug in a new class, for instance, or for one that has required a greater outlay for research and development.

According to the pharmaceutical press, health minister Lord Howe told a conference last week on the future of innovation and drug research and development that Nice was now “somewhat redundant” when it came to deciding the cost-effectiveness of drugs, although its role in producing guidance would remain very important. Howe said the price to be paid would reflect “everyone’s agreed perspective” on its value.

Dr Richard Barker, director general of the Association of the British Pharmaceutical Industry, said he thought it was right that Nice should no longer be able to accept or reject a drug for the NHS. “It should be a clinical decision on what medicine a patient needs, informed by a broader sense of value than the current one that Nice applies,” he said.

He envisaged that Nice would continue to look at the effectiveness of a medicine and give advice, but then the drug manufacturer would meet with the NHS to discuss the price. “We believe a more productive way forward based on some kind of broad assessment of value is for the company to sit down and discuss the outcome of that with the department of health and the NHS, rather than have another body set up. We don’t think there is a disagreement between us [the industry and the government],” he said.

Value-based pricing would replace the current complicated system known as the PPRS (pharmaceutical price regulation scheme), which reimburses companies for the drugs they supply to the NHS. The industry has defended the PPRS in the past, but Barker said he thought it would support the new system – as long as existing barriers were swept away.

At the moment, there are some regional bodies assessing the usefulness of medicines and PCTs have pharmacy advisers and formularies – lists of drugs they are willing to buy – which the industry hopes will all go.

From: http://www.guardian.co.uk/nice-to-lose-new-drug-power

Almost 1,000 GPs are being paid more than £200,000 a year with the average wage topping £100,000, new figures have shown.
Ten percent of GPs earnt between £150,000 and £200,000 in 2008/9

Some 700 GPs were paid between £200,000 and £250,000 in 2008/09, an increase of 50 from the previous year, according to data from the NHS Information Centre.

A further 250 earned more than £250,000, slightly down from 260 in 2007/08, according to the figures, which cover full and part-time doctors in the public and private sectors across the UK.

The average wage for a GP working under a contract last year fell for the third year in a row to £105,300, down from £106,100.

A breakdown of the figures showed 14,020 GPs – 42 per cent of the total – earned £50,000 to £100,000, while 12,820 (38 per cent) earned £100,000 to £150,000 and 3,280 (10 per cent) earned £150,000 to £200,000.

A spokeswoman for the Department of Health said: “While there has been an overall decrease in GPs’ earnings, we must ensure better value for money from the overall investment in the GP contract, and make sure resources are used to the greatest benefits of patients and the taxpayer.

“The coalition Government recently announced a two-year pay freeze for all NHS staff earning more than £21k a year.”

She said the Government was currently considering how this could be applied to groups such as GPs and dentists.

The figures also showed the rise in GP salaries over the last decade.

In 2008/09, average income before tax for GPs on a general medical services contract was £99,200 compared with £51,500 in 1998/99.

According to the Information Centre, this latter figure is equivalent to £65,900 in real terms at 2008/09 levels.

However, it said GP contracts and the nature of work has changed over that period.

Fiona McEvoy, from the TaxPayers’ Alliance, said: “Though GPs do an important job, their salaries have increased at an astonishing rate over the last decade, despite the fact they’re working fewer hours.

“These salaries show the folly of ring-fencing the NHS budget.”

From: http://www.telegraph.co.uk/Almost-a-thousand-GPs-earn-more-than-200000

The scale of NHS pay scales was highlighted in a Health Direct post:
More than 300 NHS executives have a larger salary than the prime minister on August 25, 2010 when an investigation found that 320 hospital, ambulance and health authority chiefs are paid more than David Cameron’s annual salary of £142,500.

http://www.healthdirect.co.uk/2010/08/more-than-300-nhs-executives-have-a-larger-salary-than-the-prime-minister.html

Nine thousand public sector staff are earning more than Prime Minsiter with the majority- 6,500 working in the NHS.
An investigation by BBC1′s Panorama and the Bureau of Investigative Journalism suggested the numbers earning more than David Cameron’s £142,500-a-year are significantly higher than previously thought.

Based on the responses to more than 2,400 Freedom of Information requests to public bodies, they show that 38,000 were paid over £100,000 while 1,000 received over £200,000.

They include GPs, teachers, police chiefs, council officers and senior civil servants, as well as senior managers in the BBC itself.

Cabinet Office minister Francis Maude insisted that it should not be necessary to offer “stupendous amounts” of money in the public sector.

“You can square the circle of having really good people not on telephone number salaries and massive built-in bonuses,” he told the programme.

“That public service ethos is very important. People will come and work in a public sector for salaries that aren’t competitive in a private sector sense.”

The NHS was the sector found to have the the highest number of staff earning over £100,000 – 26,000 – with almost 6,500 paid more than the Prime Minister.

Those with salaries topping the PM’s included 1,465 GPs – 10 of whom received more than £300,000. The highest earner was an unnamed GP working for the Hillingdon Primary Care Trust with pay of £475,500.

The programme also highlights salaries in the BBC where 97 managers earn more than £160,000, 160 get more than £130,000 and 331 are on over £100,000.

The Civil Service has 241 senior officials receiving as much or more than Mr Cameron, with 26 in the Ministry of Defence, 22 each in the Department for Business and the Cabinet Office, 18 in the Department of Health, and 13 in the Foreign Office.

The overall figures compiled by the programme did not include publicly-owned corporations which operate on a commercial basis – some of which have very highly paid bosses.

From: http://www.independent.co.uk/nine-thousand-public-sector-staff-earn-more-than-prime minister