Professor Alan Maynard reviews the reasoning behind government proposals for spending another £200 million on new cancer drugs not recommended by NICE health technology appraisal

The Conservative manifesto pledged an additional £200 million to fund cancer drugs, which the previous government and NICE had been reluctant to fund.

Is this a good idea?

The answer to this simple question is it all depends on what you are trying to achieve.

Karl Marx argued that history repeats itself: the "the first time as tragedy, the second as farce".

The Liberal Conservative coalition government seems to be reversing this sequence.

Number 10 has now put up its notes on the Health Bill.

It states that the main elements of the Bill are:

"To establish an independent NHS Board to allocate resources and provide commissioning guidance, and to allow GPs to commission services on behalf of their patients.

"To improve efficiency and outcomes by strengthening the role of the Care Quality Commission and developing Monitor into an economic regulator to oversee aspects of access and competition in the NHS.

In a spectacular exclusive with major policy implications, HSJ states that Health Secretary Andrew Lansley plans to abolish England's 10 strategic health authorities (SHAs) by April 2010, once his national commissioning board is established.

This policy was a Liberal Democrat manifesto commitment.

The story suggesst that not all the SHAs' 3,752 non-medical staff would be signing on directly: some might work at new GP commissiong consortia; others at "new regional offices of the independent commissioning board".

Further to this recent post pointing out that only one of Secretary Of State For Health The Rt Hon Andrew Lansley CBE MP’s four tests for service review is empricially measurable, it was interesting to pick up this DH press release.

The DH release says that Lansley “outlined new, strengthened criteria that he expects decisions on NHS service changes to meet. They must
- focus on improving patient outcomes;
- consider patient choice;

The DH has outlined the new ministers' bits.

This announcement makes it clear that the responsibilites are broadly as follows:

Simon Burns MP - Minister of State for Health, portfolio includes:
Legislation
NHS Performance
Health Services
Reconfiguration of Services
Patient Safety
Application of Quality Regulation
NHS Workforce
Mixed Sex Accommodation
Connecting for Health

Paul Burstow MP - Minister of State for Care Services, portfolio includes:
Long Term Care Reform
Adult Social Care

Further to our last story on Asda's incursion into health policy, it was interesting to note (via a news link on the excellent Dr Grumble blog) that the country's first supermarket-based GP service has lost its funding from the PCT.

This press release from Wal-Mart subsidiary Asda catches the eye, for several reasons.

The concept of cancer provokes fear that is both wholly rational (the thought of our own bodies' cells trying to kill us) and can lead to irrationality. Perhaps it is a sign of an age without religious faith that cancer - practically a pseudonym for death, rather than the long-term condition it will one day be - has acquired doctrinal status within the church of healthcare.

Writing in today's Daily Telegraph, Health Secretary Andrew Lansley outlines his four criteria for NHS service change.

He writes of the key tests, "First, there must be clarity about the clinical evidence base underpinning the proposals. Second, they must have the support of the GP commissioners involved. Third, they must genuinely promote choice for their patients. Fourth, the process must have genuinely engaged the public, patients and local authorities".

The Coalition Agreement starts with three words, in 56-point type – Freedom, Fairness, Responsibility.

Let’s judge what it specifically says about health policy (and related issues) as such.

And policy people, you now have your three key words for the next period of government. Think FFR at all times.