A A Gill exposes the covert rationing he was unaware of – until he became ill..

NHSreality is content that Nivolumab (Bristol-Myers Squibb) is not yet approved for the UK Health Services by NICE. NHSreality is not happy that it is covertly rationed, and that some people will be covered for it either by their wealth, or by Private Medical Insurance. The Drug Data sheet is complicated but clear. Survival at 12 months is improved, and the relative chance of being alive compared with no treatment at 12 months is 3 fold. However the absolute chance of survival is low… and it looks very much as if it merely delays the inevitable, and with a low quality of life.


Despite the cost of over £100,000 per annum it has been approved for some conditions. Giles Sheldrick and Olivia Lerche report in The Express 7th December 2016: Blood cancer breakthrough: New immunotherapy treatment nivolumab approved for use (In lymphoma). This is good news. However, if we are going to ration health at the expensive (fearful because none of us can afford it) pole, we need to do it overtly rather than covertly. My personal preference would be the ration high volume low cost treatments, and be able to afford the new technologies, but still feel that there is “Too much chemotherapy”…. This is an area where the greatest savings and improvement in quality of life could be made.

A A Gill rightly exposes the covert rationing he was unaware of – until he became ill.. But proper end of life care would be better value..

BBC News 10th December – AA Gill: Sunday Times critic dies after cancer diagnosis and AA Gill: Final article describes cancer fight: The Full English

Image result for full english breakfast

BBC News 20th November 2016: Writer AA Gill diagnosed with ‘the full English’ of cancer

Lucy Bannerman in The Times December 12th reports: AA Gill was denied £100,000 ‘weapon of choice’ cancer therapy

Dead people don’t vote… End-of-life care ‘deeply concerning’

“Too much chemotherapy”…. This is an area where the greatest savings and improvement in quality of life could be made.

Child cancer results improving. In a “cradle to grave” Health Service we are not doing badly at cradles.. but we are doing badly as patients approach their grave.

The NHS and reckless election promises. How about posthumous voting?






This entry was posted in A Personal View, Good News, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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