Tuesday, July 08, 2008

Private drug helps cancer man left to die by NHS

Aint socialized medicine wonderful?

A cancer patient sent home to die by the National Health Service has seen his health improve after he cashed in his pension and used funds raised by friends to pay privately for an expensive drug. Andrew Crabb, 49, a father of three from Abingdon, Oxfordshire, was told by doctors in October that there was no treatment available on the NHS for his advanced kidney cancer. His wife Diane, 57, was told that he had months to live.

The couple refused to accept the death sentence and have raised enough money to pay for the drug Sutent, at a cost of about 3,000 pounds a month. Oxford Radcliffe Hospitals NHS Trust has agreed to allow Crabb, a former bricklayer who has nine grandchildren, to pay for the medicine privately while continuing to receive NHS care. The hospital is one of at least six trusts in England and Wales which are ignoring government guidance that patients who pay for drugs privately must forfeit NHS treatment.

Alan Johnson, the health secretary, claimed that the arrangement, known as “top up” or “co-payment”, creates a two-tier health service. But he has been forced to order an inquiry into the ban after a revolt by the medical establishment, which is outraged that NHS cancer patients are being turned away after paying privately for drugs recommended by doctors. Nottingham University Hospitals NHS Trust, ABM University NHS Trust in Bridgend, the University Hospital Birmingham NHS Foundation Trust, Weston Area Health NHS Trust in Somerset and the Royal Marsden NHS Foundation Trust in London have also allowed some of their patients to pay for drugs privately.

If Crabb was forced to pay for all his care, including scans, consultants’ appointments, nursing care and blood tests, his bills could double. This weekend his wife, who works part-time as a sales assistant, revealed how she had refused to accept the NHS advice. “They said there was nothing they could do,” she recalled. “I just begged the doctor. I said, ‘You are not telling me that there is not a drug available for my husband?’ “I told her that my sister was diagnosed with cancer 10 years ago and she is still here. I was begging her to find a drug.”

Crabb has Sutent delivered to his house by a private firm, Healthcare at Home, while he continues to be treated by doctors at Churchill hospital, part of Oxford Radcliffe Hospitals NHS Trust. He is halfway through his second six-week course of the drug and doctors have observed an improvement in his condition.

Diane Crabb said: “Everything has continued within the NHS except the Sutent. There has been a vast improvement in my husband. He is walking into town, which he couldn’t do before. One day he walked for 4½ hours.”

As Crabb can no longer work, the couple have cashed in two pensions to help to pay for their living costs, while the drug is being funded by donations from friends and family. “One of my husband’s friends started the fundraising and it just escalated,” said Diane Crabb. “A friend of Andrew’s mum and dad gave 2,000 pounds. An old lady stopped Andrew’s mum in the street and gave 5 pounds. She said, ‘That’s all I can afford’.”

Karol Sikora, an oncologist at Hammersmith hospital in west London and medical director of CancerPartnersUK, a private cancer treatment company, said: “It is outrageous that this patient was sent home to die. His ability to top up his care by sacrificing his pension to buy the drug is a scandalous reflection of our times, but may save his life.”

Baroness Ilora Finlay, president of the Royal Society of Medicine, said doctors should tell patients about private drugs from which they could potentially benefit, even if the cost appeared prohibitive.

Last week Johnson promised to tackle the cancer drug “postcode lottery” by ordering the government’s rationing body, the National Institute for Health and Clinical Excellence (Nice) to speed up its assessments of whether new drugs should be funded by the NHS. He also reiterated that patients have a right to drugs once they have been approved for prescription on the NHS. Nice has yet to decide whether Sutent should be funded. However, some NHS trusts have already chosen to offer it to patients, which campaigners believe makes a mockery of government promises.

The Sunday Times has been campaigning on behalf of cancer patients who have had their NHS care withdrawn because they have chosen to pay for private drugs recommended by their doctor. A spokesman for Oxford Radcliffe Hospitals NHS Trust said: “We would have no reason to withhold treatment if a patient purchases other drugs from outside the NHS.”

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Another Big Endorsement of Shari'a in the UK

Islamists seeking to impose aspects of Shari'a law in Britain received a major boost last week from the nation's top judge, Lord Phillips. Speaking at a London mosque, Phillips opined that Muslims should be permitted to have marital and financial disputes decided according to Islamic legal doctrines. Stephen Hockman QC, a leading barrister and former chairman of the Bar Council, elaborated on the chief justice's reasoning:
Given the world situation and our own substantial Muslim population it is vital that we now look at ways to integrate Muslim culture into our own traditions. Otherwise we will find that there is a significant section of our society which is increasingly alienated, with very dangerous results.

One could only wonder how Shari'a, which mandates an inferior status for women and has inspired an array of baroque investment mechanisms, would benefit either the UK or its Muslim community in the adjudication of marital and financial cases.

The debate over the role of Shari'a in Britain has taken center stage during the past year, particularly among senior clerics. Archbishop of Canterbury Rowan Williams sparked a furor in February when he argued that adopting provisions of Shari'a "seems unavoidable" and would improve social cohesion. In Williams' view, the notion that "there's one law for everybody and that's all there is to be said, and anything else that commands your loyalty or allegiance is completely irrelevant in the processes of the courts - I think that's a bit of a danger."

Williams came under heavy fire from Bishop of Rochester Michael Nazir-Ali, who contended that incorporating Islamic law into British law is "simply impossible . without fundamentally affecting its integrity." Specifically, Shari'a "would be in tension with the English legal tradition on questions like monogamy, provisions for divorce, the rights of women, custody of children, laws of inheritance and of evidence," along with "freedom of belief and of expression." Many of Nazir-Ali's arguments have been echoed by Williams' predecessor as archbishop, George Carey.

The British government already promotes Shari'a finance and awards additional welfare benefits to Muslim men with more than one wife. However, Downing Street quickly distanced itself from Phillips, reiterating that "British law should be based on British values and determined by the British Parliament."

That politicians on both sides of the aisle have thus far resisted calls to formally sanction Shari'a law for dispute resolution is cause for optimism; that so many prominent figures keep issuing such demands is cause for pessimism.

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