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
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