tag:blogger.com,1999:blog-37603352.post1256211615361633209..comments2023-05-02T04:46:16.510+00:00Comments on Martin McKee's blog: NHS privatisation - we are right to be afraidMartin McKeehttp://www.blogger.com/profile/05654848515875160991noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-37603352.post-29968721198304355222012-12-26T18:01:38.375+00:002012-12-26T18:01:38.375+00:00Here's an example of where the private sector ...Here's an example of where the private sector is not effective. <br /><br />Some cancers are close to the central nervous system and conventional x-ray radiotherapy, though effective with many cancers, may cause damage to nearby tissues and potentiall cause more harm than good. In these situations proton beam therapy (PBT) is effective because the beam is smaller and directional. However, PBT is very expensive. Each PBT installation costs around £150m, and at full capacity can treat around 750 patients a year (figures from DH). DH estimates that every year there are around 1,500 people in the UK with the specific cancers that can be treated with PBT but not with other forms of radiotherapy. Consequently, the DH has approved two PBT units for the UK (that is, all of the devolved NHS's will use these units). At the moment UK patients who need PBT are sent to the US at an average cost of £110k per patient, this cost will fall to about £40k with the UK units.<br /><br />The US units are mostly commercial, consequently they need to have as many patients as possible to provide a return on investment acceptable to investors. Rare cancers are rare, and there is a much bigger and lucrative market with common cancers and so PBT is being marketed as a treatment for prostate cancer. The problem is that PBT costs about twice as much as conventional x-ray radiotherapy and yet there is no evidence that it is any more effective. There is competition in PBT in the US, but this is not, and cannot, bring the price down to that of x-ray radiotherapy. The flip side of private provision - convincing people that they need a treatment that they do not need - is pushing up the overall cost of healthcare in the US. And then there is the issue that if there are so many patients being treated inappropriately with PBT, will there be the capacity for those patients whose conditions can *only* be treated with PBT?<br /><br />The DH looked into private provision of PBT in the UK but found that commercial companies were not interested because that they could not make a profit. The UK model of care that is appropriate to the condition, is cost effective and equitable: it cannot be beaten.richard.bloggerhttps://www.blogger.com/profile/10589364986804437392noreply@blogger.com