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12 September 2005
Addressing the nation’s health – postcode lottery continues in the North East
Alimta funding rejected by some PCT's
Further cases are emerging of what is being described as the postcode health lottery, where patients in certain parts of the country are not receiving the newest and best treatments because guidance on what should be available is not being implemented.
The latest case concerns Bernard Hoyland from Redcar & Cleveland on Teesside. Mr Hoyland developed problems with his chest in December 2004 and was eventually diagnosed with the asbestos related cancer mesothelioma in March 2005. Following his diagnosis, Mr Hoyland was informed that he had a terminal condition and was offered only palliative care. His oncologist then informed him that a new form of treatment called Alimta® (pemetrexed) was available, which appeared to be considerably better than the drugs previously used. Despite these drugs being funded in Scotland and other parts of England, Mr Hoyland’s Primary Health Care Trust has rejected funding the drug.
Mr Hoyland comments: “Many companies and successive governments knew about the dangers of asbestos for many years but continued to use it, taking shortcuts and saving money. Finally a drug is available that can better treat the deadly cancer caused by asbestos exposure but again, to save money, those who need it simply can’t get it. It’s cruel.”
New cases of mesothelioma are increasing rapidly in the UK
Ian McFall from Thompsons Solicitors’ specialist asbestos team who represent Mr Hoyland explains: “Further cases of the cancer postcode lottery are emerging, where patients such as Mr Hoyland who have been diagnosed with mesothelioma, and told that they could benefit from Alimta, are being forced to decide whether to pay privately for treatment which can cost in the region of £24,000.”
New cases of mesothelioma are increasing rapidly in the UK. It is estimated that over 1,700 people are diagnosed with mesothelioma annually in the UK alone. This figure is likely to rise each year and peak at 2,500 patients in 2015 due to the delay between exposure to asbestos and onset of the disease.
Mr Hoyland was exposed to asbestos during the course of his employment with ICI and William Press from 1958-1980, where he was employed as a fitter by both companies and was required to remove asbestos lagging from pipework by smashing into the hard outer layer. He then worked alongside the laggers whilst the fitters dismantled the pipework and machinery. In the early years, the warnings about the dangers of working with asbestos were minimal and little respiratory protection was offered.
The Audit Commission found a third of English NHS trusts were unable to introduce all recommended treatments in 2002-3. The report blamed poor financial management, as many were not assessing the costs of forthcoming treatment. But health managers said rises in the price of drugs had caused problems.
The Audit Commission looked into whether English NHS trusts were taking National Institute for Health and Clinical Excellence (NICE) guidance into account in their financial planning.
NICE, which supported the Audit Commission's investigation, advises the NHS on what new drugs and technologies should be provided as well as reviewing existing treatments from time to time. NHS trusts should normally be assessing the financial implications of draft NICE guidance, but just 26% did, the Audit Commission report said.
The report, compiled from a survey of 71 trusts and visits to 16, was unable to pinpoint exactly what proportion of NICE recommendations had been implemented. But it said a third of trusts had identified treatments which they were unable to fund three years ago.
Many trusts said cost was the major barrier to implementation, but the report said poor financial management was more of a problem. However, the authors acknowledged payment by results, a new funding system which is being phased over the next four years, was also causing uncertainty.
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