Friday, 20 May 2011


Among all the quangos associated with health provision I think that the National Institute For Clinical Excellence is one of the better ones, Also, it’s Chairman, Prof Michael Rawlins seems to have some common sense.

We might not all agree with all of the NICE decisions, but at least we know that NICE themselves, being independent, can make their decisions on value for money in a detached manner. In fact Trusts are obliged to provide treatments which are NICE approved and their decisions can be used by clinicians to force the hand of Trusts who are slow to fulfil this obligation.

Professor Rawlins is not blind to this reluctance to provide new drugs and has highlighted the attitude of some Trusts in this article. This increasing control of consultants prescribing is something we are all familiar with, particularly in the form of local formularies. Getting new drugs onto a local formulary is usually a difficult and drawn out process, where decisions on whether a drug should be prescribable are made by a committee, which may include no-one from the relevant speciality. These committees of management arse lickers seem oblivious to the fact that, in light of the Herceptin judgement by the law Lords, enforcement of local formularies is almost certainly unlawful.

It is widely accepted that Trusts have to balance the books and savings have to be made. I think that is why most consultants have accepted our current pay freeze without complaint. A freeze which, in light of increasing inflation, actually constitutes a pay cut. 

It is nice to know that restricting new treatments to patients, and cutting consultants pay is allowing funds to be diverted to where they are really needed.

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