Tuesday, 8 July 2008


The issue of co-funding, which I understand to mean patients paying for part of their treatment on the NHS, has been much in the news lately. If I sat down and thought long and hard about it, I guess I would have to stick by the original guiding principle of the NHS: that treatment should be freely available to all at point of need. The problem is that it isn't. But should those who can afford to pay for part of their care, such as drugs like Sutent, or the one that's keeping me alive - Herceptin, continue to receive all other procedures, such as scans and bloodtests, free on the NHS? To allow this inevitably suggests a two-tier and therefore unequal system, and to me, as a socialist with a very small sss, that has to be wrong.

On the other hand, imagine (as I can only too well) a scenario where a potentially life-saving drug, trialled and used successfully in other countries, is refused to an NHS patient on grounds of cost. And imagine if that patient could pay for the drug by cobbling together the money for that, but not for all the other procedures. And imagine still further another patient who could afford neither the drug nor the other treatments, but got the other treatments and not the drug that was being bought by the person in the next bed...No, no, no... It's a moral minefield.

Why can't these drugs simply be made cheaper? I understand that there are research costs to recoup on the part of the drugs companies. But why are cancer drugs in Britain VAT rated (like children's shoes for God's sake)? Why are they more expensive here than in other countries in Europe? Why not more freely, more widely available?

All this went through my mind when I was waiting for my recent hysteroscopy down in Penzance, imagining the worst-case scenario of another heavy duty cancer treatment programme, based on the usual nightmarish number of variables (disease location and process, stage, prognosis, treatment options, etc.). The hysteroscopy showed nothing at all (in fact, I quite enjoyed the cosy cottage hospital atmosphere of the day-case ward and my pre-op visit from a charming German anaesthetist, who said he would 'proceed' away from my vocal chords, I having told him my breathing was fine because I sang...). But lying on the CT scanner bed last week, for my 6 month check, I was overcome by the sort of free-floating anxiety that usually assails me at the main hospital, where once you stray outside the oncology areas, you are subject to the usual waiting about and vague air of incompetence. What if, what if, what if...

The cure for that, of course, is life itself. Live it. Seize the day. I drove up over Dartmoor with my daughter last week, relishing the scenery of South Devon, so unlike our scenery in Cornwall, and against which I have always had my Cornish father's prejudices (I'm not a Devon person, was what he used to say - and he always went on about the parlous state of Devon's roads (Conservative mean farmers).  But last week, through my extra rose tinted cancer-survivor's specs, I saw Devon in a different light. Cricket on the lawn at Dartington; the clink of iced champagne glasses at the open air Shakespeare; the sun going down on the English meadows. 
I can understand people wanting to sell all they have to buy more time for that kind of thing. For life.

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