Scratch the surface, and it quickly becomes clear that what this fund represents is not the victory for patient groups that some believe. Rather, it is the product of political opportunism and intellectual incoherence.
The idea is that Lansley will provide £50m between now and April and then (supposedly) £200m a year divided between the ten Strategic Health Authorities (SHA). If a doctor wants to prescribe a cancer drug that has not been approved by NICE (and hence will not be funded by a PCT) s/he can appeal to the SHA panel for the money. The money is limited and so there is no guarantee that the appeal will be successful. The Lancet says that this will lead to a postcode lottery:
This raises the spectre of appeals being granted or declined not on the basis of patients' conditions, but because of where they live: either because their SHA has exhausted its share of the fund, or because their SHA is using stricter funding criteria.Further, they say that to meet the demand the fund should be £600m rather than £200m, so the same issue will continue: people will claim that they are not getting the drugs they need. The creation of this fund is purely political and is taking away the ability of experts to do what they are paid to do. Lancet comments:
Remarkably, health ministers claimed that the fund would not undermine NICE. But, let us be clear: it not only undermines NICE, it undermines the entire concept of a rational and evidence-based approach to the allocation of finite health-care resources.
We really have let idiots into the Department of Health.