NHS rationing

What is the value of a few precious extra months of life? It's a very difficult question to answer, but if Scottish Medicines Consortium's is to be believed then, it is not worth £2.5 million.

Prostate cancer is the most common cancer in men in Scotland, with 2700 cases diagnosed every year. It kills two men every day. There are 19,000 Scottish men currently living with the disease.

Last October, Alex Salmond, the First Minister, signed up to a charter calling for better treatment for patients.

The Scottish Medicines Consortium has denied Scottish men a drug that prolongs life. It said the cost of abiraterone at £3000 a month did not justify the health benefits – even though it can extend lives by more that three months .

In a letter to the Scottish government, sufferer John Thomson writes "It is a disgraceful decision, cruel and unjust, that abiraterone is not available simply because of cost. How do you evaluate the cost of drugs against someone’s life?...This drug not only gives men an extra few months but also some quality to those last few months...It is unfair for some people to access the drug and not others. Money should not be an issue."

What price a life ?

A cancer patient who was forced to pay out £3,400 per fortnight for the life-saving drug cetuximab has won his battle for funding , having previously been refused the treatment on the NHS , according to the BBC .

Originally ,the Scottish Medicines Consortium said it was not cost-effective because it could only prolong life, not cure him.

Preserving life for as long as possible should be the responsibility of the NHS , the patient is quoted as saying .

Maybe so , but under capitalism , there is always a price tag and a value placed upon a person's life . Not everyone is as fortunate as this patient was .

The Ills of Capitalism

Prescriptions issued in Scotland for anti-depressants have risen more than four-fold in less than 15 years, an NHS report has revealed. For every 1,000 people there were 85 daily doses of the drugs dispensed in 2006, compared with 19 doses in 1992.

Dr Kohli, a medical adviser for NHS Quality Improvement Scotland, said the rise was partly due to a new generation of drugs.

However Shona Neil, chief executive of the Scottish Association for Mental Health, said :-

"Social problems are a bigger factor in the increase than the new drugs - these figures show a huge cry for help from people from deprived backgrounds."

Depression affects about one in five people at some point in their lives.

An appropriate moment to promote a day-school in London at the SPGB Head Office

THE INSANITY OF CAPITALISM

Saturday 24 November from 1pm

Living in a sick society Speaker: Brian Johnson (Disability Counsellor)

Capitalism on the couch Speaker: Peter Rigg (Psychoanalytic Psychotherapist)

Whose messing with your head? Speaker: Ed Blewitt (Clinical Psychologist)

The price of a life

Certain capitalist economists accuse the National Institute for Health and Clinical Excellence of valueing the quality of human life too high . NICE judged "value for money" at a cost far higher than the NHS could afford.

The effectiveness of the drug, and its side-effects, are balanced with its cost to give a price per extra year of good health - called a Quality Adjusted Life Year (QALY).
In approximate terms, if the new treatment can deliver one QALY for £20,000 or less, then it is deemed cost-effective and heading for NHS approval. If the QALY costs up to £30,000, it may still be approved for NHS use by NICE.

The think tank The Kings Fund and City University, suggested that this £30,000 threshold was far too high when compared with how the rest of the NHS worked out which treatments to fund.
Some primary care trusts simply just pay £12000 in key areas such as circulatory disease per QALY .

Professor Nancy Devlin, from City University said "It's all about value for money... in the current NHS, where there is far less money to spend..."

The Dumbing Down of Doctors

In a previous post Socialist Courier high-lighted how the Romanian health service was reducing costs by dispensing with cancer specialists . Couldn't possibly happen here many readers may have said .

But we now read a government plan to cut senior staff in paediatric wards and neonatal units and replace them with trainee doctors will put infants at risk, doctors and patient groups have warned.

At the moment most paediatric wards have up to seven specialist paediatric senior house officers (SHOs) - doctors with up to four years' experience. Most could be replaced under Modernising Medical Careers. In future, trainee doctors with one or two years' experience will spend four months in paediatrics before moving on to another specialism, and would not necessarily have any interest in that area of medicine.
45,000 babies are born prematurely each year. Babies born at 23 weeks have a 17 per cent chance of survival and require expert medical support, while half of all babies born before 30 weeks suffer from apnea, which causes them to stop breathing.

Senior medical staff warned yesterday that inexperienced trainees are unsuited to difficult procedures such as putting an intravenous drip line into a baby's arm or treating vulnerable premature babies.

A senior London doctor said the impact on the care of vulnerable young children and premature babies could be disastrous. "Paediatrics is a specialism and, to be safe, people must be trained," the doctor said. "If things go wrong during pregnancy, you would call to the delivery an Senior House Officer who would deal with any complications. There is a big difference in a critical situation between an SHO and a trainee. These changes could result in the death of a baby or brain damage... "

Remedy UK , a 13,000-strong doctors' campaign group , accused the Department of Health of "dumbing down" doctors with MMC. "It used to take 21,000 hours of training to become a consultant but this has been reduced to 6,000. There is a move towards dumbing down the system rather than aiming for excellence," said a spokesman.

And here we read what it now feels like to be a doctor .
"...professionalism is being reduced to being a bit like just being on a production line."

First , capitalism made medicine and health into a business , run by accountants , now capitalism turns it all into a factory .

The Quick Fix

More than 31 million prescriptions for drugs such as Prozac were issued in 2006 - a 6% rise on the year before , the BBC reported .

In particular prescriptions for a group of drugs known as SSRIs, which include Prozac, rose by 10% last year from 14.7 mllion to 16.2million . There have been fears that the drugs are linked to suicidal thoughts and self-harm in some cases. In 2003, experts said SSRI antidepressants should not be given to teenagers after experts' concerns they made some patients suicidal. However, Prozac is still recommended for under-18s .

Research cited by MIND , the mental health charity, says the UK is trailing behind other countries in the use of other therapies.

The Guardian reports that levels of suicide and self-harming are soaring in mental health wards where there are few activities, locked wards and constant surveillance .
"It [ the psychiatric hospital ] can feel like a prison and unsurprisingly if people are very distressed at the time that's when they are most at risk ..."

A spokeswoman for MIND said: "Hospitals are sometimes hindering people's recovery rather than helping them to recover. There's boredom and frustration with nothing to do; with nothing to do they will think more and more about their problems and the isolation they face. It can make people deteriorate..."

The Independent on Sunday last month revealed how children as young as 12 are being incarcerated with adults in psychiatric institutions and that those children and teenagers are physically and verbally abused, left without proper therapy and housed with seriously disturbed adults.

Department of Health statistics show at any given time nearly a sixth of all adults are experiencing depression or anxiety. Mental illness accounts for a third of all illness in Britain.

More than 1.3 million older people have a mental illness such as depression and this figure will rise as the age of the population increases.

One sixth of the population suffers from a mental health problem every day.

One million people on incapacity benefit suffer mental health problems.

Mental health accounts for one third of all illness and 40 per cent of all disability in Britain.

More than 1.3 million older people suffer from depression or other mental illness.

The psychological pressures and the human alienation that people feel and experience from the effects of Capitalism carries a heavy toll . Perhaps not ALL mental illness will disappear when Socialism prevails but we can guarantee that the rates will be far, far less and those unfortunate to suffer will not be swept under the carpet , to be locked up and drugged by pharmaceuticals .

Capitalism is a Cancer

Bucharest will witness a protest demonstration of a grisly kind today. The streets of the Romanian capital will be filled with cancer patients pleading with a government that they say has turned its back on them.

More than 370,000 patients have been diagnosed with cancer in Romania but only 76,000 are in treatment, according to official estimates. This year's budget for cancer treatment has been set at 336 million lei (£65 million), a fraction of the amount spent in other EU member states. The UK, with a population less than three times as big as Romania's, spent £4.3 billion on cancer in 2005-06. Many women with breast and gynaecological cancers who had had surgery and radiotherapy are unable to get chemotherapy.

In September, the government ordered a ban on newly trained doctors joining two-year oncology [ the study and treatment of tumors ] courses to qualify as specialists - the first EU member state to obliterate the specialty of oncology - replacing it with a 4 month course instead .

The government also introduced a new system for distributing drugs to cancer patients on 1 April. Previously, it had been handled by hospital pharmacies, but now patients can take a scrip from their doctor to a city pharmacy, and take the drugs at home. But the pharmacies are reluctant to supply the drugs because of bad experiences in the past with underfunded government schemes. The Ministry of Health has big debts from past years and they are sceptical that the government will pay this time . "Cancer drugs are expensive and no one wants to invest a lot of money in buying them and then find re-payments are blocked." . Thousands of patients were left without treatment.

Organisers of the protest in front of the Ministry of Public Health accuse the government of neglecting the suffering of cancer patients. They say ministers are withholding investment because they view cancer patients as economically unproductive.

Referring to the Minister of Health, Eugen Nicolaescu, a Federation of Cancer Patient Associations spokeswoman said :-

"He is an economist, not a doctor. He sees just figures and money, not human lives..."

And what do we read in The Herald .

A spokeswoman for the BMA in Scotland said:"It is no longer financially feasible to deliver everything to all people..."We need to have a sensible debate about rationing in Scotland in context of the Scottish health service."

While Dr Andrew Walker, health economist at Glasgow University, said:-

"...the Scottish Medicines Consortium, which guides the NHS on new drugs, already performed a cost benefit analysis to determine what should be made available to patients...As an economist I would like to see the same sort of model for the other 85% of the health service"