..and the Tories carry on ignoring their pledges


5:35 pm - April 3rd 2010

by Left Outside    


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From Conservative Home:

[The Conservatives] will raise the threshold for Employers National Insurance Contributions, which will free up £200 million from the NHS budget every year. A Conservative Government would use that money to create a Cancer Drugs Fund to ensure that no cancer patient is refused access to drugs that have been licensed since 2005 if their doctors say they need them.

There are many examples of anti-cancer drugs which have been certified as safe, but which the National Institute for Clinical Excellence (NICE) has refused to make available on the NHS due to cost. So the money from the Cancer Drugs Fund will be added to the NHS tariff in order to pay for the extra cost of those drugs, meaning that doctors will be able to prescribe them without needing to apply to their Primary Care Trust for funding.

With £200 million pounds you might assume that the Conservatives would allocate it to deficit reduction. After all this is what they have told us time after time is their number one priority.

Rather than analysing and working out how this £200 million can best save lives or reduce suffering they are going to ring-fence it for their own pet project against cancer.

In fact by moving it from the NHS budget to Cancer Drugs Fund (a Quango I believe they are called) there is going to be a dead weight loss of some of this £200 million in the costs of administration. Not only is this money being used inefficiently but there will be less of it and more bureaucracy.

The Tory Party are intent on moving money around in order to make it appear as though new funds have been found when they have not. And it’s also usually moved from relatively efficient areas, but with a low media profile, to an inefficient area with a high media profile; hoping no body notices or cares.

This move highlight three things about the Tories:

  1. Deficit reduction is not the Tory’s number one priority. As Chris Dillow argued it is mere window dressing and hot air.
  2. Secondly it shows a worrying propensity – which they share with New Labour – to pander to the press rather than follow evidence.
  3. They hate Quangos and bureaucracy except when they don’t, then they love Quangos and bureaucracy because they spend money on hard working families with cancer rather than black, gay or poor people.
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About the author
Left Outside is a regular contributor to LC. He blogs here and tweets here. From October 2010 to September 2012 he is reading for an MSc in Global History at the London School of Economics and will be one of those metropolitan elite you read so much about.
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Story Filed Under: Blog ,Conservative Party ,Economy ,Westminster

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Reader comments


Actually, it is worse than you mention.

In the Tory draft manifesto they say that they want to stop the NHS from being a political football, they claim that they will make sure that there is “less political interference in the NHS”.

NICE are clinicians and are experts. If they refuse to approve a drug it is because the drug is either ineffective, or that the additional benefits of the drug over the existing treatment is far too expensive. That is an expert decision, not a political decision, but the Conservatives are saying very firmly that they will not take expert advice.

In fact, they call NICE “unaccountable bureaucrats”. Hardly a professional attitude from people hoping to be be the next government.

“They hate Quangos and bureaucracy except when they don’t, then they love Quangos and bureaucracy because they spend money on hard working families with cancer rather than black, gay or poor people.”

That’s not the very worst political philosophy of all time it has to be said.

Deficit reduction is not the Tory’s number one priority

The thing about the deficit is that it’s manageable as long as people are willing to lend to you. And they’ll be willing to lend as long as you sound like you intend to do something about the deficit. Credibility and confidence are what matters, not short-term actions. This is why all parties talk about cutting the deficit, but Labour and the Lib Dems both argue that this should be done in due course rather than as soon as possible. The Tories, it seems, actually agree with that position in private, but must publicly keep banging the drum about rapid deficit reduction in order to be the favoured choice of the financial sector.

Also, I suspect that the Conservatives will find plenty of ways to ‘reduce the deficit’ once in office, where that involves sacking public sector workers in large quantities. They just don’t want to say so now, because public sector workers can vote.

Of course, public sector redundancies may be a good thing if those being made redundant are those administering the ID card system or designing the next generation of nuclear weapons. And there’s always a few “faceless bureacrats” that nobody will miss, and consultants who could find work in the private sector anyway. But it’s notable that the Tories (unlike, say, the Lib Dems) are not telling us where the axe will fall. I think it’s fair enough to presume that the Tory ‘deficit reduction’ might involve the ‘regrettable’ loss of services and staff that tend to benefit people who don’t vote Tory or donate to the Tory party.

Good point @1, the tories are just peddling clap-trap that appeals to the emotions Cancer drugs are not suitable for all patients and to promise medication to all regardless of clinical assessment is just plain stupid.
Btw, and OT, labour’s poster depicting ‘call me Dave’ as Gene Hunt is one of the best I’ve seen during this election campaign. But I still won’t be voting labour.

they spend money on hard working families with cancer rather than black, gay or poor people

I was with you on every word of the post until this sentence, which came out of the ether of left field like a rogue exocet.

FWIW I hate quangos, beaurocracy and Tories.

6. Bill Kristol-Balls

That’s not the worst of it.

If the TV guide is to be believed, the MP for West Narnia is on HIGNFY next week.

🙁

“FWIW I hate quangos, beaurocracy and Tories”

Let’s be clear that the Conservatives propose to set up a new quango: “the Office of Budget Responsibility, that would act as a watchdog on all public spending and borrowing.”
http://news.bbc.co.uk/1/hi/uk_politics/7640179.stm

Evidently the (often critical) commentary on government fiscal policies by the non-partisan Institute of Fiscal Studies (IFS) and the NIESR aren’t deemed sufficient or competent, nor the two dozen or so independent forecasts of the UK economy, about half of which come from banks and other financial intermediaries:
http://www.hm-treasury.gov.uk/d/201003forcomp.pdf

Evidently, the Conservatives aren’t opposed to quangos in principle.

And you have to look at this and draw other parallels. Hate what the Labour government do with science by abusing the idea of having an advisory council on drugs? This is exactly the same mentality right here. Neither party cares one jot for independent advice unless it is politically advantageous for them to do so.

the MP for West Narnia is on HIGNFY next week.

No way… That might even turn into brilliant car-crash TV. Can anyone put the best bits on youtube?

10. Matt Munro

“because they spend money on hard working families with cancer rather than black, gay or poor people”.

So what ? Why are black, gay, or poor people more deserving of public resources than hard working families ? I can’t think of a single economic, moral or social reason why they should be, unless you are suggesting there should be a hierarchy of rights ?

Yeah and there is the National Audit Office as well- so the Office of Budget Responsibility is just silly.

The point about this though is it reinforces something else- that by ringfencing health from their cuts, the Tories are actually going to cut a vast amount more of everything else. If you ringfence health you effectively promise to cut education say by 25%!

Left Outside opposes Conservative proposals to give people wider access to cancer drugs – quoted as saying “Of course people need to see a cancer specialist inside a week – but that doesn’t mean they should be allowed drugs to save their lives. Our proposals will ensure people are made aware of their unavoidable fate earlier than under the Tories”

🙂

13. Matt Munro

@ 11. The NAO are auditors, that is they go in after the event and say how well or otherwise the money has been spent, when it’s too late to make any real difference. There is little apparent control over the money before it is spent, something that used to be the core task of the treasury, before they diverged into merchant banking. There are currently huge areas of government where no one appears to know what the budget was spent on, let alone whether it’s actually acheived what it was supposed to, and that needs to change. I agree with you about health, increased NHS funding does not correlate with increased outputs, so ring fencing their budget, when they are actually better placed than many departments to absorb real term cuts is daft. Because of the publics (sometimes contradictory) views of the NHS, no politician will say in public “we will cut NHS spending”, at least not one that wants to get elected.

But deficit reduction was only an issure 2 weeks ago. The tories have moved on from that now. Deficit reduction is so old hat for the lying tories.

In the last week alone they have pledged to cut more taxes and spend 1 billion on welfare for the poor middle class sops who invested in Equity life.

The cuts are going to have to be gigantic to pay for all this shit. But then that is what the tories really want to do because they have not changed one bit. In fact they are even more right wing than they were before. People are wrong to compare Cameron with Blair. The beter example is GW Bush. He predented to be a moderate conservative and then once he won ( sorry had the court appoint him) he moved to the far right. Cameron will do the same.

Has anyone opened a book on the prospects for a hike in VAT from 17.5% to 20% if Honest David wins a comfortable majority at the election?

they spend money on hard working families with cancer rather than black, gay or poor people

I was with you on every word of the post until this sentence, which came out of the ether of left field like a rogue exocet.

FWIW I hate quangos, bureaucracy and Tories.

A bit of polemic never hurt anyone!

In all seriousness I do think there was an element of playing to the gallery in that. I knew certain people would guffaw and others would think “typical lefty nonsense.” I suppose in doing so I have lessened the power the post has on convincing people not already convinced one way or the other.

I might try and calm that sort of stuff down in the future.

@Matt Munro – The fact is you can be a hardworking, black, poor, hardworking female head of a household. It was a bit of a throwaway line implying that the Tories care only about some quasi-mythical hard working family rather than other people who also happen to be hardworking but not in the particular social or economic grouping that garners sympathy.

@Everyone.

I’m not against people getting cancer drugs, but I am against wards closing because some cancer drug of dubious merits (hence not approved by NICE) is foisted on the NHS.

@16: “I’m not against people getting cancer drugs, but I am against wards closing because some cancer drug of dubious merits (hence not approved by NICE) is foisted on the NHS.”

One of the main objectives in establishing NICE in the first place was to take NHS prescribing out of the political arena by rooting prescribing firmly in the clinical evidence of effectiveness balanced against prescribing costs and any potential risks from the adverse side effects of drugs.

The effect of this Conservative pledge to open up the range of permissible cancer drugs is to put NHS prescribing practices back in the political arena.

In which case, why continue with NICE? Let’s be honest and consistent about this and make prescribing decisions a regular issue for ministerial decisions subject to ministerial accountability and debates in Parliament.

The costs saved from abolishing NICE can be put back into the NHS. Of course, some of us will follow FDA reports in America even more closely than now. To its everlasting credit, FDA stopped the prescription of Thalidomide in America years before the drug regulatory authorities in many other countries:
http://en.wikipedia.org/wiki/Thalidomide

If the TV guide is to be believed, the MP for West Narnia is on HIGNFY next week.

Farage…Dorries…presumably they’re working through the comedy MPs from each party before the election (see Stephen Pound for Labour and Charlie Kennedy for the LibDems)

19. Matt Munro

“One of the main objectives in establishing NICE in the first place was to take NHS prescribing out of the political arena by rooting prescribing firmly in the clinical evidence of effectiveness balanced against prescribing costs and any potential risks from the adverse side effects of drugs”.

I think that’s a bit naive, NICE is a quango, who pays the piper calls the tune and all that. I certainly perceive what the state will and will not fund in terms of drug treatments to be political. It’s not possible to de-politicise state funded medicine, or probably private medicine either.

Worse than that, I think NICE is an example of this governments obsession with taking professional responsibility and judgement away from the professionals and moving it to whitehall. Doctors should decide who gets treated and who doesn’t, not civil servants.

20. Matt Munro

@ 16 Fair enough – although I think the phrase “hard working family” was first aired by that nice, hardworking Mr Blair………….

@19: ” Doctors should decide who gets treated and who doesn’t, not civil servants.”

Rubbish. The trouble is that doctors cannot be trusted to make sensible, informed prescribing decisions, hence the Thalidomiode tragedy in the 1950s and why we needed this recently:

“One of the country’s most commonly prescribed anti-obesity drugs has been banned across Europe after it was blamed for increasing patients’ chances of suffering a heart attack or a stroke.

“The European Medicines Agency (EMA) ordered doctors across the continent to stop prescribing sibutramine and told pharmacists not to dispense the drug, which is marketed in the UK as Reductil.” [January 2010]
http://www.guardian.co.uk/lifeandstyle/2010/jan/22/reductil-banned-in-europe

Civil servants advising ministers about NHS prescribing would need to take clinical advice from professionals. Much better to have that advice, with the clinical rationales, open and published as in current NICE reports.

My GP put me on a drug which I was subsequently taken off by an NHS hospital consultant because the drug is associated with cardiac risks, an issue first publicised by the FDA in America.

22. Matt Munro

@21 “Rubbish. The trouble is that doctors cannot be trusted to make sensible, informed prescribing decisions, hence the Thalidomiode tragedy in the 1950s and why we needed this recently”

I suspect they would disagree, and argue that they have probabluy forgotten more about medicine than a whitehall pen pusher ever knew. Your argument is like saying that because some plane crashes are caused by pilots, all pilots are imcompenent, all the time. By hey, we should never underestimate the power of strongly held opinion over empirical knowldge.

The fact is doctors have a long and expensive training and need to reach exacting professional standards to practice, civil servants don’t. I would trust my doctor, who I know and has known me for 10 years, in a way that I cannot trust a Whitehall bureaucrat. What seems to happen with alarming regularity is that doctor reccomends drug to patient, NICE say no, we don’t approve, patient dies.
Turn it round, if they let doctors be doctors, they wouldn’t need to take advice. And I don’t believe for a minute that doctors were soley responsible for thalidomide (which is why the manufacturers, not the Doctors were sued) or that the same couldn’t happen again with a quango running the show. I can’t comment on your own treatment but practically all drugs have potentially lethal side effects, even the ones you can buy in a chemists without going anywhere near a doctor, or a bureaucrat.

@22: “I suspect they would disagree, and argue that they have probabluy forgotten more about medicine than a whitehall pen pusher ever knew.”

First division Whitehall administrators don’t pretend to know or second guess the basis for clinical decisions about prescribing, which is why they would take professional clinical advice in advising health ministers about NHS prescribing practice.

Much better to have that professional clinical advice out in the open, together with the associated rationales, as in current NICE reports, rather than put NHS prescribing back into the political arena, which is what the Conservatives are doing with their pledges about cancer drugs.

@22: “The fact is doctors have a long and expensive training and need to reach exacting professional standards to practice, civil servants don’t.”

The fact is that there is a long and sad, documented history of GPs prescribing from habit drugs which turn out to have seriously adverse or even fatal side-effects. This is precisely why we need regulatory authorities such as the FDA in America, the European Medicines Agency (EMA) and NICE or its equivalent in Britain, to issue prescribing guidance and not leave precribing guidance to the whims of ministers subject to lobbying by the pharmaceutical companies and pressures from meeja trying to boost circulations.

This whole issue has become the more important with the promoted cost-saving trend towards Polyclinics – or local care centres – where patients may often be seen by physicians they have never met before and may never see again.

And btw, why have the Conservatives decided to liberate only cancer drugs from NICE guidance? What about drugs for cardiac conditions, strokes, MS, diabetes etc etc? The whole business looks thoroughly whimsical and headline-grabbing electioneering to me.

24. alienfromzog

‘And btw, why have the Conservatives decided to liberate only cancer drugs from NICE guidance? What about drugs for cardiac conditions, strokes, MS, diabetes etc etc? The whole business looks thoroughly whimsical and headline-grabbing electioneering to me.’

That is exactly what it is.

http://angrymob.uponnothing.co.uk/home/70-newspaper-lies/992-sick-and-wrong


Reactions: Twitter, blogs
  1. Liberal Conspiracy

    ..and the Tories carry on ignoring their pledges http://bit.ly/bh3sB4

  2. Dave Harris

    Comments on this are worth reading RT @libcon ..and the Tories carry on ignoring their pledges http://bit.ly/bh3sB4

  3. sunny hundal

    RT @leftoutside: ..and the Tories carry on ignoring their pledges http://bit.ly/bqcxQL





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