NHS Moral Dilemma

More need, less available resources ... the NHS continues to be painted into a corner with a new round of confusion that underscores the inevitabilty of viability problems in the future.

A decision will be made by NICE in two weeks on whether local health authorities will have to fund the cancer drug Nexobar. This drug is touted to extend the lives of people with terminal cancer, adding an optimistically-estimated 6 months to 2 years ... all at a cost of about GBP3000 per month! (Cost shouldn't matter, should it?)

As a result, the NHS has made the decision to spend 1 million GBP over the next three years on a kwango to spell out to NICE, the implications of approving new expensive drugs!

And this, of course, raises a whole littany of issues!

First, for those who stand to benefit from access to a drug of this nature...

The view of one patient interviewed by the BBC was that the NHS is putting cost before peoples' lives, effectively consigning him and others in a similar situation to the "scrap heap". Why spend money on a kwango when peoples' lives hang in the balance?

Good point ... if you raise an expectation level it sets a precedent. And that's exactly what has been done. In an attempt to be all things to all people, the system has become inefficient and the result is that even more people suffer.

Then, what about NHS managers who are given a budget to work with? The money has to come from somewhere, so which initiatives "matter less" and get the axe?

People watching BBC Breakfast were quick to mention a wide variety of supposedly gratuitous beneficiaries, ranging from IVF treatments to the care of those who abuse their bodies and take "unreasonable" risks.

But I thought morality was objective in a civilized world.

Then, there's NICE who is ultimately responsible for the viability of the whole system. Where do they draw the lines without creating anger and disparity? Simple ... screw everybody, just a little.

And then there are the drug companies who create these miracles but need a malleable system to maintain the viabilities of the profit train. That's a lovely tie you have there Sir ... thank you for your cheque.

So ... as this whole scenario is inextricably linked with morality, I thought I'd indulge myself and play agent provocateur for the day. And please, before anyone actually takes me seriously and believes this to be anything more than the harmless musings of a dyed-in-the-wool cynic ... relax!

I am just a mere devil's advocate. And an underpaid one at that!

So, here goes. Reality check!

If you are terminally ill and there is no reasonable chance of cure, expecting the tax payer to fund a life extension drug is completely unreasonable. The drug has no chance of curing you.

Sorry. That's the hard truth. I wish things were different, but money is tight.

Once a precedent is set, drug companies will continue to pressure the system for the opportunity to supply more exensive band aid solutions. And they can get away with that because no-one likes to see people suffer in any situation.

Again, the hard truth. On a clinical (callous) macro level, all these chemicals do is skew the life expectancy statistics exactly as I pointed out in my previous post. I realize it's virtual heresy to say that.

But it's also the truth.

The NHS does not have the money, so why is it even going down the road. You can't make promises you are not in a position to honor.

Get real!

The fact that it needs to blow a million pounds that will add absolutely no value to the quality of anyones' lives in order to effectively lobby for common sense to prevail ... only serves to prove the system is light years away from achieving it's broad objectives.

Why doesn't someone step in and stem the bleeding. Where is the leadership and the fiscal sanity?

Fix it before the cheque is written. Oh, but that would horse up the unemployment statistics and impinge on other budgeted revenue streams.

Why are we perpetuating an environment where drug companies actually have us feeling like we are beholden to them? If we stop indulging them they will quickly change their strategy and develop products that add more value for the bucks available.

Economics 101?

Of course, the real answer is to rechannel our energies into preventative measures that are not profitable, but actually work.

Perhaps even the man on the street may eventually grasp the wisdom of such an obvious soultion.

We are dependant on the drug companies because we have been brainwashed at a profound level to think that they are improving our health and making us all live longer.

Wake up folks!

Of course they aren't. Our health is not declining because of a shortage of drugs. It's because we have no idea how to take care of ourselves or our children and have abrogated all responsibility to a sytem that profits by supplying symptom mitigation, not solutions.

And because we cry for relief, we actually think they are the good guys. That's a brilliant business model!

But it's actually so efficient at creaming money from us that it will be the architect of it's own undoing. Hows that for irony?

Why?

Because we will continue to fuel a growing organism with money we don't have. Like the global economy, something has to give. Just do the math. Expectations and reckless promises don't pay the bills.

Kwangos, management mentality and oceans of rhetoric will not make things better. What is needed is true leadership and no-one is willing (or able at this point) to step up to the plate.

What would they even say?