Sunday, August 16, 2009

British cancer patients denied life-saving 'near-label' drugs

Thousands of cancer patients are being denied drugs that could extend their lives because of restrictions on supplying medications outside their licensed use, campaigners say. Almost 3,200 patients have been forced to plead for funding from the NHS for so-called “near-label” treatments – medicines licensed for use in some cancers, but not in other, similar forms of the disease. In the past three years, 1,053 applications for funding were rejected by local primary care trusts (PCTs), meaning that patients had either to go without or pay up to £20,000 for treatment.

The figures, uncovered through Freedom of Information requests to every PCT in England, are published today by the Rarer Cancers Forum. The charity says that the problem arises because the National Institute for Health and Clinical Excellence (Nice), which assesses drugs for NHS use, cannot recommend a treatment outside its licensed use.

After a review of access to cancer treatments last year, Nice promised to speed up its processes and consider the greater value attached to some drugs designed to treat terminal conditions. However, where drugs could be used outside their licensed fields, doctors have to apply to local PCTs for funding to use a drug on a case-by-case basis, generating a postcode lottery of access to the treatments.

Stella Pendleton, executive director of the Rarer Cancers Forum, said: “The NHS is forcing desperate patients into the cruel situation where the chances of their being given the treatment they need depend on where they live. “No patient should be denied a treatment recommended by a doctor simply because the cancer it treats is too rare for the medicine to be licensed. We need these obstacles removed. “Drugs companies, politicians and the NHS have a responsibility to patients to fix this system.”

The Department of Health said: “Doctors can use their clinical judgment to prescribe any treatment that will benefit their patient, even if it is outside its licensed indication. “Such decisions need to be made in discussion with the patient concerned and funding may need to be agreed with the local PCT. “Where NICE guidance is not available, it is only right that local PCTs should continue to make these difficult funding decisions according to the needs of their local population."


Leftist Britain's abolition of selective schools has given a free run to the children of the wealthy

Selective schools gave bright working class kid a chance at reaching the top. Now they languish in mundane occupations. So much for the pursuit of equality

Leading professionals are becoming less intelligent, researchers said yesterday. Lawyers, doctors, accountants and bankers were all cleverer a generation ago, a study found. The startling conclusion was reached by academics looking into social mobility. They wanted to find out why those born into poor families in the 1970s were much less successful than those born in the 1950s.

The research found that as poor children in the 1970s lost the chance of a good education - often blamed on the abolition of grammar schools - they were not able to reach the top professions. Instead, the places were filled by those from wealthier families - who were not always as naturally gifted.

The researchers from Bristol University based their findings on IQ tests taken by ten and 11-year-olds as part of two major surveys into the lives of children born in 1958 and 1970. They found a decline in IQ among those in the best-rewarded and highest-status professions between the two generations. It means professionals now in their 50s are likely to be brighter than those in their late 30s.

Ratings from the tests give someone of exactly average intelligence a score of 100, with broadly average intelligence running from 90 to 109. Between 110 and 140 is regarded as superior intelligence.

It found that lawyers born in 1958 had IQs about 10.5 per cent above the average when tested as children - in the superior bracket. But those born in 1970 had IQs nearer to 7.5 per cent above the norm, putting them into the average bracket. Similarly, accountants from 1958 were nearly 10 per cent above average, but only 6 per cent above average in 1970. Bankers' IQs fell from 7.5 per cent above average to 6.5 per cent, while university lecturers dropped from 9 to 7.5 per cent above average. Doctors were 12.5 per cent above average in 1958, but 11 per cent above average in 1970.

A handful of professions showed that the 1970 generation were at the same level or more intelligent than their older colleagues. These tended to be those of lesser status, with less clearly laid out career paths, or with more egalitarian traditions. They included nursing, science, engineering, art and journalism.

However, the researchers - led by Lindsey Macmillan from the Centre for Market and Public Organisation at Bristol University - offered a crumb of comfort to those who worry about whether their GP is up to the job. 'Somewhat reassuringly,' the study said, 'doctors and scientists and other medical professionals exhibit the highest IQ test scores over time.'

Labour has consistently blamed the fall in social mobility on universities shutting out youngsters from less wealthy backgrounds. But critics say the problem lies with comprehensive schools that fail to help poor pupils develop and achieve good grades. They point out that the major difference between the two generations born in 1958 and 1970 is that the former were educated in the era of grammar [academically selective] schools.


Dim British science teachers

Four out of five trainee science teachers have fewer than 2 A levels. If you were bright, why would you want to teach in a chaotic British "Comprehensive"?

Four in five students training to be science teachers on undergraduate courses have fewer than two A levels, says a report, and only 58 per cent of all students on undergraduate teaching courses have two A levels or more.

Last year there was a dropout rate of about 40 per cent between the final year of teacher training and taking a post in a state school, while a further 18 per cent left the profession during their first three years of teaching. There has also been a steady decline in the number of men teaching in secondary schools and only one in seven primary school teachers is a man — a figure that has not changed since 1998.

The report, the Good Teacher Training Guide, says that there is a wide variation in the grades achieved by entrants to teacher training, according to discipline. For those who entered teacher training after taking a degree, 42 per cent had a 2:1 or better in maths, 43 per cent in modern languages and 47 per cent in science. This compared with 61 per cent in geography, 78 per cent in history and 90 per cent in classics. “For those at the bottom [of the chart], filling places was evidently a struggle,” the report says. “Besides maths, this was true of modern languages and science, where the availability of biologists masks the shortage of physicists.

“It appears there are two cycles. In one, there is competition for training places, high completion and the successful are snapped up by schools. “But in the other, places are difficult to fill, the relatively low entry qualifications are associated with high dropout from courses, and there is a poor conversion rate of trainees to teachers. “This is the situation in core subjects like maths, science and modern languages.”

The report added: “It is extraordinary that we have to train almost double the number of teachers as are actually needed. “A contributory factor to the dropout, which we have highlighted in this report, is the poor qualifications of those recruited. “Raising entry qualifications, therefore, would seem to be a way of reducing waste. But if potential trainees do not come forward in sufficient numbers then the providers cannot select and qualification levels will remain low.” [Wow! You figured that!]

Professor Alan Smithers, of the Centre for Education and Employment Research at the University of Buckingham, co-wrote the report. He said: “These figures must be a cause for concern. Teacher trainees in crucial subjects seem under-qualified and the training process seems very wasteful. No one would, I think, suggest that having a good grasp of one’s subject is not a very important aspect of teacher quality.”


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