Sunday, 27 September 2009

Wonder why this wasn't the case already...

Cheap drugs to save NHS millions

Health bosses in East Riding have revealed plans to save money by prescribing cheaper, non-branded drugs.

The region's primary care trust (PCT) believes the move will slash £3.5m from its budget.

NHS East Riding of Yorkshire aims to achieve the saving across its 39 GP practices by March next year.

The question I have to ask, and excuse me for being a little dim, is why the PCT weren't already using generics where possible in a bid to save money for the taxpayer. The issue of Statins aside (because I don't claim to have the medical knowledge to comment on the appropriateness of their use), if a generic drug is confirmed to be as effective as the branded one, then what's the point of paying the mark-up simply because the pharmaceutical company used to hold a patent on the drug.

"Ah", you may say, "those nasty cheap generic drugs just aren't as good", well there is a case for double-blind testing if ever I saw it. With finite resources (something that people often forget when saying "everyone should only get the best"), decisions need to be made about what can and can't be afforded by the NHS.

And now, if you will excuse me, I would like to offer a slightly different idea for you to consider. Currently, the government has the monopoly on healthcare, both in terms of supply (NHS) and payment (central government payments to NHS). So if you want to get treatment for something, you go to a doctor (employed by the NHS) and he treats you (by the government supplying the money to him). If you have no money, society says "that's ok, we believe that everyone should have access to healthcare, so we'll pay for it", which I hope is accepted as the right and proper thing for a developed country to do. The government having a role in the supply of resources is clearly a vital part of this equation, but what that role is and where there is a necessity for them to also be effectively the sole supplier of care is more questionable. What about the Singapore system where people have individual healthcare bank accounts which they pay into every month (and which the government will top up for those unable to pay in, for instance those out of work) which can then be spent on whatever healthcare they desire? If the government owned hospital says "we will provide that treatment for £100" then why shouldn't a patient be able to look at other private hospitals who will also offer the service for £100 but which will provide a service more suited to them. What about if the person thinks "actually, I'm willing to pay a little more for that treatment to get my own room for my stay" or "I don't think it's worth £100 paying for some of the extras I won't use, I'll use this private hospital who will do it for £75"? It's cost the government (and therefore the taxpayer) nothing extra to do this, universal free healthcare is still firmly in place, but suddenly the motivation to cut costs isn't coming from above (central government) but from below (patients being able to go elsewhere if the price offered for a treatment isn't competitive with what the market offers). If this all sounds a little far fetched and out there, might I suggest reading "The Plan: Twelve Months to Renew Britain" by Douglas Carswell and Daniel Hannan, or at the very least the chapter where they discuss how healthcare could be both less costly and provide better results at the same time. Oh, and if you feel tempted to Google for Daniel's name, don't overlook his blog since a lot of the invective directed at him is answered there.

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