Monday, 10 November 2014

The Debate - NCRI Cancer Conference II

Picking up where I left off, the motion for debate was "This house believes that the Cancer Drugs Fund has been good for British cancer patients".

A quick bit of (rather over-simplified) background - although the NHS is a national service, each of the individual home nations has its own healthcare policies affecting the way the NH Service is delivered locally. The Cancer Drugs Fund operates in England as a means of improving access to drugs not routinely funded by the NHS.  Some of the drugs funded are waiting hopefully for NICE approval, while others have been considered to be too expensive for routine use.  There has been quite a bit of controversy over the fund and the press abounds with stories and, at the moment, particularly stories of people in Wales not having access to drugs that might well be available to them through the fund if they lived in England.  The Fund has been criticised for funding drugs which NICE has already (and often controversially!) rejected.

So this was an interestingly framed debate.

As someone well used to debate and the putting of arguments for and against a case, attending the debate was an interesting experience…

There were speakers from each of the home nations, two for and two against.  The format was an initial setting out of the position with regard the background to the fund and the funding for non NICE approved drugs in each of the four nations, followed by an initial straw poll which resulted in support of the motion.  After that Peter Clark of NHS England spoke for the motion followed by Tom Crosby of Velindre NHS Trust (in Wales) speaking against.  Next came a time for questions from the floor and then David Cameron (no, not the one from Downing Street, but the David Cameron, from the Edinburgh Cancer Research Centre!) replied for the motion and finally Martin Eatock from the Northern Ireland Cancer Network replied against.

In practice, the only one who really spoke to the motion was David Cameron.  The others tended to raise very valid points, but points which were not really "on topic", being more about overall fairness than whether British cancer patients had benefited.  They addressed the fact that patients with conditions other than cancer don't have access to specialist drugs funds and discussed that not all the devolved nations have access to the fund or something similar.  While it may be unfair that people with other conditions can't access non-NICE approved drugs, that doesn't mean cancer patients haven't benefitted from it!  And although Welsh cancer patients haven't benefited, English patients have and English patients are British, while the motion speaks only of British cancer patients, not British cancer patients from all parts of the UK. It was, after all, the choice of those who make healthcare policy in Wales not to have such a fund and they are convinced that a cancer drugs fund should not be introduced in Wales.

As a result, I'm not at all convinced that the vote taken after all four speakers had spoken was actually on the same motion on which the straw poll was taken.  The final vote was overwhelmingly against the motion.  It would be interesting to see what might happen if the same things were said but the debate was held with a very different audience.  Many of the British cancer charities are in favour of the fund.

Still, very valid points were made, whatever the motion might have been and it was all good fun!

I will move onto Tuesday's sessions in the next post.

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