Why a Nice drugs debate gets so tough

DEBATE over whether the full range of NHS-approved drugs should be made available in Guernsey shows how difficult it is to have a dispassionate discussion on an emotive topic in a small community.

Why should islanders be denied life-enhancing or -extending treatments on cost alone? Powerful though that argument is, it misses a fundamental point. Price already influences availability, which is why the UK has an established approval process.

Yet that is a world power with 66 million people, high rates of tax, 2.5m. dollar millionaires, more than 50 billionaires, is Europe’s major global finance centre – and still can’t afford every new drug that comes on to the market.

Surely all deputies would acknowledge Guernsey is cash-strapped. But the demand is for the island to conduct itself as an English micro-county rather than, as Sark and Alderney do, recognising some things are beyond its means.

Providing a rare-cancer treatment can cost £530,000 a year, fantastic for that individual and family. But the difficulty is how, or, indeed, whether, society should question the value of that for the wider community. A cure? Certainly. Delaying the inevitable? How long justifies the expense?

These are uncomfortable questions but the NHS and HSC recognise there can never be enough money available to pay for all new treatments.

Should the argument switch to priorities? Best-in-class access to treatment funded by, say, a second-rate education system? Or fewer police on the beat?

The problem with emotive subjects like this is how hard it becomes to discuss consequences. Establishing the rights of the individual is an absolute while the reality is a tax increase or reduced service for someone else who, in the kindest sense, has no interest in or attachment to the individual seeking expensive treatment.

In the UK, such considerations rarely play out in public. Here, there’s an energetic campaign that actively seeks publicity. It’s well meaning, compassionate and effective.

But what remains inescapable, no matter how successful it is, someone else pays the price.

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