Being NICE about drugs

I'd written quite a long blog about this and it suddenly disappeared; I was still puzzling how to get at the copy blogger saves automatically, when it auto-saved the blank message on top of the original. I shall put a short note here now and add to it as I remember what I said before. This time I shall make sure the text is saved by posting it at frequent intervals, so anyone who finds a partly written and uncorrected blog will know why.

I suspect some rationing of expensive treatments by the NHS is essential to avoid a state of affairs where the entire gross national product is spent on medicine, but I have misgivings about the details. Drugs withheld include some that extend the lives of kidney cancer patients by as much as six month, yet the NHS does provide free cosmetic surgery for the removal of tattoos, and one alternative use of funds I heard cited as more deserving then the cancer patients was the treatment of people with cystic fibrosis. Both tattoos and cystic fibrosis are avoidable. Tattoos may be avoid by not having them, and cystic fibrosis, which is a genetically determined condition, would be avoided if people who are carriers avoided mating with other carriers. In both cases prevention should be quite easy.

Quite apart from the details of treatment permitted and treatment withheld, there is one practice that I find particularly objectionable.

If patients decide to pay for drugs that the NHS does not provide, those patients are punished by being required to pay for all their treatment.

I think that is spiteful and vindictive, and points to a disturbing aspect of the welfare state, a suspicion of anyone who tries to look after themselves instead of throwing themselves on the mercy of the state.