I’d be lying (a lot) if I said I understood or followed politics. I definitely used to feel a little bit guilty whenever I saw that politics TV campaign a couple years ago (2 guys chatting in a pub. one says he’s not interested in politics and then his chum doesn’t let him talk about anything because politics affects pretty much everything).
However, occasionally something in the political world makes my ears prick up. Certainly, the live pre-election TV debate was an entertaining spectacle and more recently this NICE kerfuffle seems intriguing.
NICE is to lose its power to decide which drugs are available on the NHS, its opinion being downgraded to a mere advisory status. The power is to be dissipated to local GP consortia.
It’s a move I’m not sure I get. Granted this may be due to the aforementioned level of my political understanding, but there’s a couple of things that niggle…
Has NICE been doing a bad job, doesn’t it have the expertise in this area? The one criticism I’ve come across is NICE has misread the public mood. I’m not sure how I feel about this – smacks of PR a touch. I didn’t think it was NICE’s job to read the public mood, but to make an informed, evidenced based decision.
Are GPs better placed to make these decisions? Will it affect the patient/physician relationship? Will GPs have to put up with patient lobbying? A lot of the new drugs, e.g. cancer drugs, will be used in small patient populations by secondary care specialists. Does it make sense to have GPs approving these drugs?
Lastly, I just don’t get how this manoeuvre is going to work in a time of austerity. We’re supposed to be tightening the belt, but this seems to be involving more parties (and so more money?) in the decision-making process – NICE will still exist, making a recommendation, in addition to everyone else that will now be involved. But primarily, if change has been brought in to ensure drugs needed by few to improve/prolong life (no matter how short this effect lasts) are prescribed when previously rejected, how on earth is this going to save money? Or are we exacerbating the postcode lottery, where only the areas that can afford these drugs will prescribe them?