[back] Sikora

[These Allopaths can say anything and get away with it, a classic in bullshit propaganda: A medical miracle; a revolution in public health; mankind on the threshold of a longer, healthier lifespan than anything dreamed of in the old Biblical prescription of three score years and ten; no wonder such tremendous news was blazoned all over the front pages yesterday.  Medical miracles like his chemotherapy!  Now the Statin fraud marches on.]

We're lucky to live in an age of medical miracles. What we desperately need now is a health care service to match

By Professor Karol Sikora
Last updated at 12:43 AM on 11th November 2008

A medical miracle; a revolution in public health; mankind on the threshold of a longer, healthier lifespan than anything dreamed of in the old Biblical prescription of three score years and ten; no wonder such tremendous news was blazoned all over the front pages yesterday.

Just consider what has been achieved.

In a major clinical trial conducted in 26 countries - including Britain - a statin drug (designed to cut cholesterol in the blood) has been found to reduce the rate of heart attacks by 54 per cent, strokes by 48 per cent and combined risk of heart attack, stroke and heart-related deaths by 47 per cent.

Cancer specialist: Professor Karol Sikora hails a new drug that cuts the risk of stroke and heart attacks

Crucially, the American-based study of the drug Crestor involved people who would not normally be considered particularly liable to heart problems, opening up the possibility of perfectly healthy individuals taking tablets on a regular basis to extend their lives.

So dramatic are the findings, the trial - conducted under the name Jupiter - was halted in March, only halfway through its planned four-year run.

Such a step is highly unusual, but Crestor is so effective that researchers understandably thought it would have been unethical to continue giving placebos to half the patients taking part in the study.

In short, we are witnessing a major breakthrough in preventive medicine. So how long can it be before millions, in this country and abroad, start demanding this remarkable new drug as a precaution, even if they don't seem particularly at risk of developing cardiac problems?

And therein lies the rub. Wonderful though medical breakthroughs undoubtedly are, they all have consequences. And the most obvious consequence in this case is the issue of pounds, shillings and pence.

Yes, Crestor is not especially expensive as far as the individual patient is concerned. It works out at around £25 a month, or £300 a year. But how do we pay for it if it is prescribed for a million patients, ten million or even more?

How do we allocate resources, when the NHS is already struggling to afford the very expensive new drugs that are being developed all the time?

Of course this isn't a new problem. In my own work as a cancer specialist I have seen first hand the anguish of patients who just can't get the drugs that may prolong their lives. The NHS can't - or in some case won't - pay for them.

Yet until very recently, sufferers were actively discouraged from paying for the treatment themselves. If they went private they risked losing their free access to the NHS.

So some of the most ill and vulnerable people in our entire health system were forced into an agonising choice, all for the sake of a bureaucratic notion of what constitutes 'fairness'.

Well, the Government has at last seen the light. Patients can now opt to pay for the new drugs they need without losing their right to an NHS hospital bed.

But with the dazzling prospects held out by Crestor and all the other drugs coming on stream - in the treatment of cancers, arthritis and so many other conditions, quite apart from heart disease - the problem isn't nearly over yet.

After all, if the hard-pressed NHS can't afford the whole galaxy of amazing new drugs, we'll presumably have to extend the principle of co-payment, so that patients themselves stump up.

The principle of a health service free at the point of use will inevitably be eroded even further.

The outlines of a looming crisis in the system are already apparent.

Noble though the ideals of the health service undoubtedly are, it is already creaking under the strain of ever more expensive treatments and ever-higher expectations from the patients. And those strains are inevitably going to get worse.

Take the remarkable progress made in the Human Genome Project, which will soon offer every citizen the opportunity to buy a personal DNA profile that assesses their likelihood of developing any one of a whole range of diseases.

The cost of such a DNA 'map' is coming down all the time and could be as low as £500 within a couple of years. For that price, any one of us could get advance warning of the diseases that are likely to afflict us and - thanks to the new drugs becoming available - take precautions against them.

Money well spent, you may think. But again, who pays?

I think it was Enoch Powell who years ago argued that the cost of universal health care could swallow up our entire GDP if we didn't set limits. He had a point.
 

And it isn't just the cost of treatment that should cause us concern. Medical miracles have huge social consequences, too.

Consider this: when the Queen was crowned in 1953, she sent out just 212 congratulatory telegrams that year to those Britons who'd reached their 100th birthday.

Last year, she sent out more than 4,000 such messages.

The truth is that we're already living longer, thanks to better medicine and a greater individual awareness of how to look after our own health.
 

We must be grateful, of course. No other generation has been so fortunate. But we can't ignore the problems that come with an ageing population.
 

Can we be sure that the army of people living in care homes are being treated with the dignity they deserve?
 

Can we go on fobbing off care workers with the minimum wage?
 

Can we cope with a shrinking workforce and the ever-growing cost of pensions?
 

Such concerns will become ever more acute in the decades ahead.
 

Crestor isn't the only drug that will extend our lives. Indeed, such is the pace of medical advance that we could one day develop a pill that will cure just about everything.
 

There is no reason why our average lifespan - at present around 78 - could not be extended to 85 or more.
 

We should already be preparing ourselves for what could, if we are not careful, turn into a social nightmare. But are we?
 

When the term of a government is only five years, it's a rare politician who takes a longer-term view.
 

Unless that changes, we are in danger of bequeathing some real headaches to our children and grandchildren.
 

So what should we do? However much we love the NHS - and it is a great institution - we must recognise that it can't keep pace with the speed of technological advance.

With huge strains already apparent, we have to think differently if we are to have a health service fit for the demands of the 21st century.
 

Yes, we need a core system of care to which everybody has access. But don't we also need a system of compulsory insurance so that patients can get the very latest drugs which the NHS can't afford?
 

Shouldn't we encourage co-payments, so that individuals have some control over the treatments they get?
 

Of course, it may be argued that such an approach will lead to a two-tier NHS, with the rich having access to expensive drugs, while the poor make do with what they are given.
 

But does it really have to be like that?
 

With imagination and political will, there is no reason why health care in Britain shouldn't be both effective and fair. Our European partners seem to manage it. Why can't we?
 

Unless we do, a service designed in the conditions of the 1940s just won't be able to cope with the high-tech 2020s and beyond.
 

We are privileged to be living in an age of medical miracles. Shouldn't we count our blessings and seize the opportunity for change?
 

• Professor Karol Sikora is a cancer specialist and Medical Director of CancerPartnersUK.