Costly Silence

The National Institute for Clinical Excellence (NICE), a UK government agency charged with deciding whether drugs should be subsidized by the British government, has been criticized by some patient groups for refusing to approve new and expensive drugs. Groups including the National Kidney Federation, the Arthritis and Musculoskeletal Alliance, the National Rheumatoid Arthritis Society, Beating Bowel Cancer, the Royal National Institute for the Blind and the Alzheimer's Society have all objected against NICE decisions. "All of these charities received sums of up to six figures from drug companies in 2007," reports Jeremy Laurance, the health editor with The Independent. "A positive decision by NICE on a drug not only guarantees sales to the NHS but can influence global markets worth billions of pounds. Yet none of the charities named has criticised the high prices charged by the pharmaceutical companies for their products in their recent campaigns," he wrote.


In 1999, shortly before relocating to London, I had a lung infection and spent ten days in the local (US) hospital getting tests and bills that totaled well over $60,000 — and not even a diagnosis. I tell that story whenever I hear bitching about the NHS. Jaws drop. What people complain about, incidentally, is never the socialist side of it, but the effect of New Labour's privatizing moves. Doctors are still just interested in healing people, not writing invoices or pushing drugs; neighborhood pharmacies are helpful too. Imagine — free health care for all, funded by a modest tax on income. How is this possible?

The NHS accepts that people are not immortal, and people who are dying are less immortal than others. A million pounds spent dragging out a painful cancer death for another two months is not a good investment. Endless tests and treatments to deal with a condition that'll go away on its own, or never amount to much, are not a good investment. Hypochondriacs are not indulged, except with gentle good humor, friendly concern, and respectful explanations. Midwives handle most births. By holding back on the frills and excesses, the NHS manages to provide the necessities — most of them anyway, almost always, sooner or later. Less than perfect? Life isn't perfect; we all die regardless of medical care. How well the NHS works can be seen in how it's treated by politicians — even free-market Tories know the NHS is sacred in public opinion, perhaps more than the church or the royal family ever were. Even New Labour's own cabinet ministers join the picket lines when the government tries to shut down a hospital; his "reforms" of the NHS perhaps did as much as Iraq to turn the public off Blair.

Probably the greatest single threat to all this are the always-overpriced and often-unhelpful drugs promoted by these questionable patients' advocacy groups.