Education and Health Not Always a Level Playing Field; AGENDA

Article excerpt

Byline: SARAH EVANS

The two great foundations of our welfare state both came out for an airing last week. Education and health are never far from the front pages but their political and moral basis is not as frequently rehearsed as their irritating, individual foibles and various falls from grace.

By a happy coincidence, various public statements from both sectors have coincided to throw into relief the questions that are implicit in any state system.

NICE, the National Institute for Clinical Excellence has the unenviable task of telling doctors which drugs they can use and which they can't.

That body has to decide how the always 4nite resources of the state can be used.

Whether or not the rest of Europe and the States approve a drug, unless NICE has deemed it good or cheap enough for us, it cannot be prescribed on the National Health.

The current dilemma is what if the patients buy the drug themselves?

What if they have read all the websites, done all the research that is now available, know that specialist doctors the world over are recommending it and decided this is the drug they want to take and can pay themselves for it?

At the moment the answer is tough luck. NICE knows best. You can't have it.

And, what is more, if you dare to go ahead and order it off the internet or whatever, we will never let you darken the doors of an NHS-funded institution again.

Well perhaps not quite never. We might possibly treat you if you break your leg during an expensive skiing holiday or turn over your Aston Martin, but if you dare to move out of line in your cancer treatment, not one penny of national health money will come your way.

You will be punished for daring to step outside the state.

Professor Mike Richards is conducting a review into top-up payments for treatments within the NHS - a thankless task given the strongly held views on one side by doctors and politicians that such a concept is intrinsically unfair and patients on the other, who resent the threat of being denied NHS treatment when they have paid taxes all their working lives.

"It is not possible to 4nd a solution that meets everyone's aspirations," announced the said professor this week. …