Sue NHS if managers deny approved drugs says NICE

Patients should sue their local health authorities if they deny them drugs deemed cost effective for use on the NHS, the head of the National Institute for Curbing Expenditure (NICE) has said in a excellent example of the pot calling the kettle black.Sue NHS if managers deny approved drugs says NICESir Michael Rawlins, chairman of the killer quango watchdog, said “numerous trusts” were “acting unlawfully” in denying patients Nice approved treatments. Health trusts were wrongly using “delaying tactics” before allowing them, to save money, he said.

Sir Michael urged patients not to stand for such behaviour, saying courts would without doubt side with them.

He made clear his comments in an article for the Health Service Journal about problems many patients were having accessing a Nice-approved treatment, called dexamethasone intravitreal implants, for the common eye condition retinal vein occlusion. Installed every six months, the implants help prevent sight deterioration.

He said: “Quite clearly numerous trusts are acting unlawfully. They are denying patients an innovative and cost-effective treatment, recommended by Nice, that significantly improves their quality of life.

“The reason, of course, is that trusts do not wish to use their resources in this manner. Although they know that are required to make Nice-approved products available, they introduce delaying tactics.”

Disputes between primary care trusts (PCTs) and hospitals over payment meant “many months pass with the arguments going back and forth”, he added.

His advice was that organisations such as the Royal National Institute of Blind People (RNIB) should seek a judicial review in the High Court.

“The court would unquestionably uphold the claim,” he predicted.

However, he added such case would not reach court – the implication being that trusts would quickly back down if threatened with the prospect of costly legal action.

He noted that the NHS Constitution enshrined the patient’s right to Nice-approved drugs “if your doctor says they are clinically appropriate for you”.

The RNIB had found 37 of 125 hospital trusts were either not providing the dexamethasone implants or providing a restricted service.

Sir Michael also said NHS managers should show more allegiance to patients and less to their trusts.

“I want my clinical colleagues to start exercising leadership and ‘whistle-blow’ when their trusts fail to meet their legal obligations,” he said.

Steve Winyard, head of policy at the RNIB, who raised the matter with Sir Michael, commented: “If Nice has done all the detailed work on cost effectiveness then I think it’s inappropriate is for PCTs or hospitals at local level to make decisions that run counter to that.

“Nice doesn’t come to these decisions lightly and it would like to see patients across the county benefit.”

Last autumn it emerged that about a quarter of PCTs were blacklisting more expensive drugs, even if Nice-approved, in favour of cheaper ‘generic’ versions.

In January Andrew Lansley, the Health Secretary, promised to introduce an “effective compliance regime” to end “postcode prescribing” of Nice-approved treatments.

Health authorities often put pressure on doctors not to prescribe certain treatments if there are cheaper alternatives available.

However, health authorities themselves are under intense pressure to use ever more limited resources as efficiently as possible.


Comments are closed. Posted by: Health Direct on

Tags: , , , , , , , , ,