It is three days after writing ‘Concerning the Commonwealth!‘, I stand by my piece. I think that the Commonwealth is facing increasing issues all over the field and as the numbers go up and up and up, healthcare will take a centre seat in a diminishing population of workers, which by the way include issues that will hit Australian shores too. Today (at http://news.sky.com/story/1287088/government-has-lost-control-of-the-nhs) we get to see more about the NHS, the mention of a 3 billion pound fiasco, which gets attached to the name Andrew Lansley, who is currently Leader of the House of Commons. He is also behind the Health and Social Care Act 2012, which is regarded to be highly controversial. However, before we go into any controversial parts, try finding a document called ‘ABPI UK NHS medicines bill projection 2012 – 2015‘, it is a PDF file (the Google link was too messy). There is a massive revelation on page 5, which diminishes a bible chapter with a similar name to a mere Paddington bear story.
As we ignore earlier mentions of a shake-up gone awry at 3 billion and mentions of an IT structure at the price of 10 billion that never worked, here we see that over the term 2013-2015 the use of brands go up from 14.2 to 15.5 billion, yet generic medication needs only rises from 3.2 to 3.9 billion. The interesting part is that even though there is still a brand growth, the bio-similar mention (generics) go up from 134 to 328, so there is more than 100% growth in change to generic medication, whilst the cost is still growing steadily on both sides (generic versus brands), what would the brand side have done if the generic side did not exist?
Three days ago I was extremely outspoken in regards to the need to get the NHS costs down. It seems that the search for generic alternatives is taking a backseat to other options. In an age of finding ways to make ends meet, the Health and Social Care Act 2012 has no space reserved in regards to the need for a stronger presence of generic medication.
When we look at:
233 General duties
(1) In exercising its functions NICE must have regard to—
(a) the broad balance between the benefits and costs of the provision of health services or of social care in
England,
(b) the degree of need of persons for health services or social care in England, and
(c) the desirability of promoting innovation in the provision of health services or of social care in England.
Why was the following not added?
(d) the choice of generic medication where possibility for a responsible health care alternative warrants it.
Now, I will be the first one to admit that my choice of words is not the best one, but it seems where it is known that generic medication is such an important part for the survival of the NHS, that no mention at all (as far as I could tell) seems to raise a few more questions. Key message 4 on page 11 of the PDF shows exactly the part that matters: “Nine of the current top 20 selling brands lose patent exclusivity between 2012 and 2015” and when we consider the growth through bio-similars, we see that the right path seems to be taken as we read the numbers from the office of health economics. So, there is a path to better growth through managed costs (to some degree), the question becomes, why is this report quoting Jane Ellison as secretly taped? More important, why is Sky News not giving proper light to the NHS issues as they are (to a small extent) resolved? Why are they not taking a look a Professor Adrian Towse, Jon Sussex, Lesley Cockcroft or Martina Garau. I would think that the latter two as statistician and economist might be able to light a candle in the tunnel of ambiguous ‘tell tailing’ darkness ‘some’ are sailing.
None of these matters are coming to light at any stage. Even the Guardian on April fool’s day, did little more then http://www.theguardian.com/society/2014/apr/01/health-service-biggest-challenge-history-nhs-boss. I will admit that the article of the Guardian was decent, yet the quote “the NHS is facing a perfect storm of rising demand, funding pressures and worryingly low staff morale“, no matter how true, seems to be about the hardships (which remain true). Yet the information that the Office of health economics seem to have is escaping these Journo’s of bad news writings. Slide 13 of the initial PDF shows an even stronger view on how the UK is getting by, whilst the US is facing an overall hike from 176% to 281% compared to the UK index, Only Spain, Finland and France were barely better off. That part remains in question when we consider their population, if the results was correctly weighted (small oops on that slide), then the pressures for patent change from American shows just how desperate the American position is, which is shown even stronger on slide 6 when we see just how hard medication hits both Japan and USA as they spend well over 2% of GDP there, whilst the population of Japan is twice that of UK and the population of the USA is set at well over 400%. These slides will also leave is with other questions in several regards, yet the initial positive view is not reverberated over the press sites, or by the UK journalists. It seems to me that the information by certain newsgroups, especially in the LACKING sight on the importance of generic medication leaves us with questions. However, the Guardian was all over the business side of Pfizer trying to take over AstraZeneca. Did no one properly wonder why they were willing to dish over 69 billion? When did a US company EVER spend such an amount unless they knew that they would end up with double the amount? When we consider those events, we should wonder why the papers aren’t a lot more outspoken in regards to informing the public.
Even if this was all not true, don’t you think that the press would (should is a better word) have been all over the members of the Office of health economics I mentioned asking them the questions I am voicing and a few more after that? Is the silence of the press not deafening? The late April article in regards to Pfizer – Astranezeca headlines as ‘Pfizer refuses to guarantee UK jobs if AstraZeneca takeover goes through‘, which should make us wonder whether this is about income, jobs or patents. Would that takeover stopped any patents, or at least delayed them? If many patents have 1-2 years left, why pay that many billions, which information was kept hidden from us? It is the quote from Pfizer CEO Ian Read that states “The combination of Pfizer and AstraZeneca could further enhance the ability to create value for shareholders of both companies and bring an expanded portfolio of important treatments to patients.” This is a fair, honest (to some degree) and clear message. It is about the shareholders and the message that these billion will come back to ‘us’ and then some. This is clear business, I do not object, yet the overview for the UK? What will it cost them besides jobs? We saw little of that and the NHS has been played like a piñata donkey for a little too long. This is not me stating that the NHS is okay. Actually it is far from that, it is about getting the proper illumination on events, which does not seem to be happening either.
In the end, the quote in the Sky News article “A spokesman for the Department of Health told Sky News: ‘Giving operational control for the day-to-day running of services to doctors was the right decision but we’ve always been clear that ministers are responsible for the NHS’” might have been a correct one, the added information could have been a lot more insightful. When you Google ‘Office of health economics‘ you will not find any links to any newspaper, which is puzzling when you go to the Office of health economics and look at some of their publications. If I would add one more ‘light‘ remark then it would be that the members of the editorial and the policy board of the Office of health economics seem to have more degrees then a Kelvin scale, making them in my mind an essential source of health information for any journalist.
So where are these articles informing the public?
Lawrence van Rijn - Law Lord to be 