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I have a chronic condition and to purchase my drugs on the NHS is more expensive than if I buy three months (not 30days as given by my GP)supply of the identical drugs in Spain over the counter. The drugs are often made in Europe and shipped over here and we are being penalised for the total waste of NHS funds because they do not argue the price in the UK. It would not happen anywhere else. Good luck with the book.


I read your article about NICE in the Sunday Times with great interest. However, my point is that inequities remain in this process. The use of high-cost drugs and new drugs is scrutinised by PCTs as you quite rightly mention in the article. However, millions of pound are spent by PCTs on management costs and this spending is not scrutinised in the same way. I would not struggle personally with the concept of NICE so much if similar rules were applied to the rest of NHS spending. On the one hand PCTs argue over spending, in some cases, only a few thousand pounds on experimental life-extending drugs yet think nothing of paying management consultants hundreds of thousands of pounds - and it is arguable how effective they are. The cost-effectiveness yardstick should be applied to all NHS spending, particularly that spent on unnecessary layers of NHS management and bureaucracy.

Martin McShane

I have just watched your programme which was outstanding. Thank you. As someone who works in a large PCT as a manager I spent the afternoon with local doctors and managers debating and making decisions about the sort of problems you so cogently aired. How do we balance finite resources against need? It was refreshing to have such a balanced view put across.

Pat Archer

An amazing insight into NICE, whilst also balancing a patients perspective with the whole issue of the prohibitive cost of drugs in the UK and their long term effectiveness. It was interesting to note that the drug manufacture conceded on price to a small degree by offering to discount the drug in the third year of use, whilst previously having stated that it generally only extended life up to two years.

I recently read an amazing book by the late Michael Gearin-Tosh, who was diagnosed with myeloma in 1994 and survived 11 years until his death in 2005, by refusing conventional drugs, chemotherapy etc and instead researching and selecting a range of alternative therapies.

Living Proof a medical mutiny is the authors personal account of how, by questioning and challenging medical attitudes and conventional treatments he ultimately took responsibility for his own life and chose his own course. A wonderful and inspiring book.

It would be interesting to see a more balanced perspective on healthcare in the UK whereby complementary and alternative therapies are brought into the equation, and evaluated by the same criteria of long term success rates and cost effectiveness.

Manjula Patel

The documentary gave a very objective balanced view in a climate of a health service that is more outcomes focused. It raises the question of how can end of life care respond to the new agenda especially in the current climate? Is the present end of life care model equipped for the future? With longevity of life and demographic changes can a medical model alone sustain the increase in end of life care or do we require a different perspective of a public health or a community development approach? We intend to raise these questions within Sandwell next Friday at a conference about Compassionate Communities which is Professor Allan Kellehear’s public health model of end of life care. Murray Hall Community Trust is organising the conference as the organisation takes a community development approach as a core principle and is evident in the Bridges Support Service, which is managed by Murray Hall. The service provides psycho-social supportive care to people living with cancer and palliative care and is co-located with the Sandwell Hospice at Home Service and John Taylor Hospice in Birmingham - both were featured in the programme. The audience at the conference will include members of the public, end of life service users and professionals. We hope the discussions will inform the future development of end of life care services in Sandwell as well increasing the public awareness about the issues related to dying, death and loss

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