Experts have raised concerns regarding a so-called ‘disease lottery’, where access to treatment depends upon the type of illness a patient has.
A recent commission for the King’s Fund, a think tank on the future of health and social care, has found that “different conditions are treated in different ways.”
Economist Kate Barker, who chaired the commission, compared the treatment received by cancer patients and dementia patients. Cancer patients, she highlighted, have their treatment funded in full by the NHS. Dementia sufferers, on the other hand, have care means-tested because it is deemed to be a social issue.
“The consequences of their illness are not the same as the consequences of cancer, but it’s luck of the draw. If you die of heart disease that’s pretty cheap but I may die of something really expensive. Instead of a postcode lottery, we now have an illness lottery”, she said.
Ms Barker recommended that all substantial care should be paid by the state, regardless of whether a patient was at home or in hospital. This would cost around £5 billion per year. “The system needs to be made fairer”, she concluded.
Cancer drugs fund
The arguments surrounding a ‘disease lottery’ have been largely fuelled by the highly controversial cancer drugs fund. Set up by the government in 2010, the fund pays for cancer treatments that have been rejected by the National Institute for Health and Care Excellence (NICE).
In 2013 the fund overspent by £32 million, meaning money which would have been used to treat other conditions had to be pulled from other areas of the NHS. John Appleby, chief economist at the King’s Fund, said this raised a “fundamental ethical dilemma. Should certain NHS patients’ lives be valued more highly than others”, he asked.
The cancer drugs fund also leaves no incentive for drugs manufacturers to keep prices down because, as chief executive of NICE Sir Andrew Dillon suggests, it means “there is no constraint on what the NHS would pay.”
Some cancer charities have endorsed the cancer drugs fund, saying it is the only way some patients can get the life-prolonging treatment they need. However, other charities believe it is inappropriate, especially while families of dementia sufferers are facing costs of £20,000 per year.
Jeremy Hughes, chief executive of the Alzheimer’s Society, says: “If you have a condition like cancer, you quite rightly expect that the care you need will be free. That is sadly untrue for people with dementia and families who are left crippled by the cost of care.”
Substandard medical care
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