I'm H.A.P.P.Y.

Shock news this morning was that people are realising that if the NHS pays for Herceptin then they have less money for anything else.

I am ready to be flamed for the following but it is a debate that is needed.

I understand why an individual would fight to be treated with Herceptin. Of course anyone who thought it would help them or a member of their family would do everything they could to get hold of it. But the NHS has a limited resource. For once I am not being political, whoever is in power there will always be limited amount of money that can be spent. And, as a group, we need to see that the more that can be treated the better. Hard choices have to be made. It seems easy to say "if you don't let me have access to the drug I will die", but the relaisty is that if one person has access to Herceptin then in fact many more die because there is no money for the other therapies.

The problem is that what we hear is individual storries. And every individual deserves to be listened to. But someone, somewhere, has to make the hard choice. Do we treat 75 people with Herceptin (with a 10% success rate) or do we treat 355 people with radiotherapy? Radiotherapy does have a lower success rate. herceptin is certainly a wonder drug. But the increase in numbers of people you can treat mean that even with a lower success rate the total number of people who survive increases. If we look at individuals then every single one should have Herceptin because they have a better chance, but if we look at the "herd" then we do better using the cheaper therapy.

It is a harsh reality. I wish that the NHS had enough money to do everything. But it is a bottomless pit, and there will always be a newer more expensive drug. The money has to be used rationally, and that means choosing what is best for us all.