A change of Hart?
This morning the door shut on some cancer patients in Wales - those suffering with renal cancer and who were hoping to get drugs called Avastin, Nexavar and Torisel on the NHS. The National Institute of Clinical Excellence announced they had not been approved as first treatment options for advanced kidney cancer or cancer that has spread around the body. They were deemed not to be cost-effective.
NICE also turned down the use of Sutent as secondary treatment options for people with either form of the disease.
In January the drugs had been made available in Wales until NICE came to its final decision. Decision made, the response from the Welsh Assembly Government and from Edwina Hart was swift and unequivocal:
"The Minister expects clinicians in Wales to follow NICE recommendations for the use of these drugs now that the final guidance has been published, although patients who have started treatment with one of the drugs not recommended by NICE should be allowed to continue treatment until they or their clinician consider it appropriate to stop."
In other words: I said in January you could carry on prescribing here in Wales even though they'd already stopped in England but now, sorry, it's over. Stop prescribing to new patients. Final answer.
A few moments ago a second statement was issued and this is it:
"The Minister is considering the NICE guidance and taking advice from clinicians". We're told to disregard this morning's statement.
The second statement is described as a "clarification". It's no such thing. It says something quite different to the first. It means that if a cancer patient saw a doctor this morning, that doctor could not have put them on any of these drugs. If they see the doctor tomorrow, they'll be told they can have them, for now.
Edwina Hart was already being accused by the former Conservative health spokesperson, Jonathan Morgan, of falsely raising the hopes of cancer sufferers and of misleading the National Assembly. Both the Tories and the Liberal Democrats castigated her for raising hopes, only to dash them.
I think the language is about to get much, much stronger.
I'm Betsan Powys, BBC Wales' political editor. I'll be blogging the inside track on 
© MMX~RS~q~RS~~RS~z~RS~28~RS~)
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Betsan:
The language will get a long stronger in the case of the N.H.S. is now rejecting certain types of Cancer Medicines for the Public Usage....
=Dennis Junior=
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Today's news is a travesty for sufferers. Stop pouring money into culture and inward looking nation building and spend it on front line services that are desperately needed by the ill and vulnerable.
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Can you imagine the fuss there would have been in the nationalist/socialist gang if the NICE decision was taken with a conservative government in Westminster?. I can imagine them in wales being interviewed by sympathisers in media with the usual result i.e1- Hard hearted conservatives only interested in money. 2- We need control over health in wales to protect our perfect NHS.What with the original desire to get people travelling from north wales to south wales for neurological surgery,and then complete disregard for views of consultants regarding management of neurology services in south wales we seem to be controlled by "mickey mouse" politicians rather than professionals who should know how to run services. Theres no doubt the Swansea decision is clouded by political self interest and not pure professionalism. When Daniel Hannen made his comments about NHS he was correct in that in wales in that it is "Stalinist",in that it is run by politicians who are consistenly second guessing professionals.
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Betsan, as the husband of a NHS employee who has suffered from FIVE reorganisations since 1979 in her employment, it is about time this most critical of services was taken away from the Assembly, and out back under the general NHS.
Had those very expensive exercises not taken place, in the face of cost cutting elsewhere in the NHS, maybe NICE would not be attempting to cut costs on the grounds of 'cost effectiveness' of these drugs today.
I simply wonder how long it will be that other less vital drugs, such as Ramipril, which both I and my wife are prescribed, will be also cut due to 'cost effectiveness'.
I am sure I, nor my wife, will actually drop dead the instant we get no more, (unless we pay for the drug ourselves of course) but my GP tells me that by using the drug, I reduce my BP somewhat and that relieves him of having me in and out of his practice on a weekly or fortnightly basis, ensuring he has more time to attend to more needful patients.
So, if I am 'cut' from my medication, and have to therefore spend increased time in his presence, who, or how many, may kick the bucket due to not being able to get to him in time to save their lives?
Today's messages, contradictory as they are, do nothing to bolster my faith in this region's NHS whilst it is retained in the hands of the Assembly.
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Betsan:
Simply off-topic but, on the issue you are discussing; What is the appeal process that will be done to allow for exemptions if possible....
=Dennis Junior=
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What is really worrying is that some people are actually promoting Mrs Hart for First Minister. She is a classic example of someone who flatters only to deceive. How can you change your mind on an issue as inportant as this to individuals within a matter of hours. As Health Minister her only 'achievement' has been free car parking. She has failed to take the important decisions on hospital reorganisation and the decision or lack of decision regarding neuro surgery is just bizarre. Sadly for Wales this is further confirmation that the Labour Party lacks the leadership talent required to take Wales through the difficult years ahead for the public sector. Wales needs politicians with the courage to take the right decisions. On this evidence Mrs Hart is yet another flip flopper when it comes to the crunch.
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I think this is a case of damned if you do damned if you don't. You could spend the whole of the budget on the NHS and it would still not be enough. Again we have the example of the mythic millionaire getting his paracetamol on the NHS, yet if we really want to spend more on the health service we either have to pay more taxes or switch expenditure from some non essential budget. I'd suggest scrapping trident would be a start. We have a real dilemma, some medication will only be of use to some for a short time, there is no suggestion that this medication will actually cure the condition, just prolong life. I'd hate to have to make that decision, should we strive to maximize life at any cost? If not were do we draw the line?
The purpose of NICE is to give advice, its up to our Ministers to make the decisions, better to change your mind within a few hours than to prolong a wrong decision.
Again we get the knee jerk reaction from some about scrapping all expenditure on culture (which would cause massive economic disruption and throw thousands out of work) despite that all culture expenditure is a fraction of the health budget, and again a swipe at nation building, what ever that is. The tories call for the introduction of charges for medicine for all those on the 40% tax rate, great, how do we administer that, will it possibly cost more to administer than it will bring in?
We need a serious debate on how the NHS will function, how far we will go and how much will we spend.
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