Let’s prescribe honesty

    Four years after the NHS created the National Institute for
    Clinical Excellence (Nice), its effectiveness in disseminating
    clinical best practice has taken another blow, with damaging
    results for people with Alzheimer’s disease and other forms of
    dementia.

    Three years ago Nice advised NHS bodies to prescribe Aricept,
    Reminyl and Exelon because of their success in alleviating some
    symptoms of dementia. But many sufferers are still struggling to
    obtain these drugs. The Alzheimer’s Society says that some parts of
    the NHS are either ignoring the Nice guidance or limiting the
    number of patients given medication.

    It is the classic post-code lottery. Because GPs themselves cannot
    prescribe these drugs, patients must wait for a place at specialist
    centres, which allows health authorities to restrict prescribing.

    Sufferers and their carers deserve transparency in NHS prescribing.
    The blurring of clinical, financial and bureaucratic reasons behind
    iniquitous health care provision does everyone a disservice.

    In 1999, health secretary Frank Dobson said: “Nice will help end
    the unacceptable geographical variations in care that have grown up
    in recent years.” Now it appears to be failing in that remit, the
    prognosis may not be good, since it finds itself on a sick list of
    NHS bodies earmarked for possible merger or abolition.

    Whether any government has the political will to admit that the NHS
    cannot afford all prescriptions that are clinically effective is
    another matter.

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