Some interventions are better than others
Boris Johnson is a surprising convert to the side of public sector intervention as opposed to market mechanisms.
Lucentis, a drug which is made by the prodigious Californian company Genentech, said to be the very originator of the biotechnology industry.
Genentech makes another drug, Avastin, and though Avastin is technically a cancer drug, it is now widely agreed to be just as good as Lucentis at treating wet macular degeneration.
There are only two differences between them. The first is that if Lucentis were free on the NHS, it would cost about £750 million a year, whereas Avastin has been on the market as a cancer treatment for years, and would only cost £4 million a year for eye patients across Britain.
Genentech has spent huge sums developing Lucentis; the stock market requires that the company earns back the cost of the research and development.
So there is no way on earth the Pharma boys are going to seek a licence for Avastin, when they would be effectively cutting their own throats.
The licensing regulations are not my forte but I have to wonder what the obstacles are to allowing people other than the manufacturers of a drug to apply for a license. Of course, accessing the relevant data might be a tad difficult.
Botox restrictions are being urged but the govt comes under fire for bottling out.
Two years after Sir Liam Donaldson, the Government’s chief medical officer, warned of a risk of permanent injury caused by the treatments, including transmission of hepatitis and vCJD, ministers have asked the cosmetic surgery industry to set up a system of self-regulation to “further improve standards”.
The announcement was attacked by critics who said it did not go far enough. Which?, the consumer magazine, said it was “disappointing” that the Government had decided to “bottle out” and “leave it to the cosmetic treatments industry to make itself safe”. It has campaigned for statutory regulation.
Although surgeons who perform face-lifts and liposuction are subject to some regulation, high street beauticians who offer Botox and fillers are not.
A surprising turn of events given that the industry has actually been asking for regulation.
The insecurity surrounding the MTAS website is covered in the media but there is not more to add to the Channel 4 report. The Times, the Guardian & the Telegraph all pile in as does the BBC.
With the application process already beset by controversy, the security breach on the site where junior doctors apply for postgraduate medical training programmes is yet another blow to the scheme.
I am not going to politicise this but the following statement tells you how much the monitoring of doctors working times is worth.
Dr Hughes’s wife said that he had been depressed and had been working 85-hour weeks, training to become a consultant anaesthetist. NHS Lothian denied this, saying he had been monitored and was working a 45-hour week. Its thoughts were with the family, it said.
Somehow I feel that the wife might have a better idea about happenings than someone relying on a form filling exercise. I have heard complaints about the futility of monitoring exercise for a long time, especially from SpRs in their final year.
The Telegraph profiles a GP who
“would vote for him (Tony Blair) again, but I’d want to see far less spin, and proper, considered health policies.”
Accessibility and public health have got better but bureaucracy, targets and central control have got worse and mine is a completely different job.
Especially for dentists with the lack of NHS provision coming up again in the Commons yesterday:
The prime minister promised in 1999 that everyone would have an NHS dentist no matter where they lived within two years.
Eight years later, less than a half of the adult population is registered - a lower figure than when Labour took office.
Yet Mr Blair has never conceded that he had broken its promise to the electorate.
However, he was directly challenged at prime minister’s question time by Liberal Democrat MP Mark Cheadle, who asked when he expected the promise to be fulfilled.
He replied: “It is and has been a real problem. I entirely accept that.
“The reason for it is very simple: even though we have increased the number of NHS dentists, we cannot stop dentists going outside the NHS if they wish to do so.
“They are entitled to do that and despite the fact that we are paying far more and hiring far more within the NHS, we have not been able to fulfil that pledge.
“However, the majority of people are actually within their area able to access an NHS dentist if they want to, but that is not 100 per cent - I accept that.
“It will only be dealt with ultimately by increasing still further the number of NHS dentists and that is what we intend to do.”
The Telegraph investigates the postcode lottery.
And Patricia Hewitt’s letter to the Telegraph garners reaction.
I am interested in this but wonder if there will be the funding from penny wise but pound foolish decision making.
Researchers said yesterday that a group of children aged three who had received two years of intensive tutoring - so-called Early Intensive Behavioural Intervention (EIBI) - had higher IQs, more advanced language and better daily living skills than similar autistic children receiving a standard education.
The intensive teaching consists of about 25 hours a week at home supervised by specialist behavioural consultants. It helps children to improve their eye contact and concentration as well as their ability to copy words or actions.
The findings mean that autistic toddlers can go to mainstream primary schools at five with a much better chance of learning and coping, and can subsequently lead fuller adult lives.
Parents of autistic children argue that while the short-term costs to the local authority are high, this should be offset by the fact that it will not need to provide residential care or intensive mental health services in the long term.
Finally, after the repudiated HSJ list of trusts under threat covered here, the DoH has released its own list of trusts in a shaky financial position.
The 13 trusts that could not afford to repay debts were: Hinchingbrooke Health Care in Huntingdon; Mid Yorkshire; Queen Mary’s, Sidcup, Kent; Royal Cornwall; Royal Wolverhampton; Coventry & Warwickshire; West Middlesex; Weston Area Health, Weston-super-Mare; and three London trusts - Barking, Havering and Redbridge; Bromley; and Queen Elizabeth, Woolwich.
The five that could not repay loans in the foreseeable future were: North Bristol; Royal United hospital, Bath; Surrey and Sussex Healthcare; the Royal West Sussex; and Whipps Cross, London.