Fingers burned

Written By: - Date published: 11:02 am, January 29th, 2009 - 20 comments
Categories: health - Tags:

Word is Tony Ryall is feeling a bit burned over the herceptin funding. Turns out the private specialists needed to administer the treatment are going to cost a wee bit more than he expected. That’s right, the scheme has been locked into legislation without being properly costed and now the government is stuck with the bill.

I guess they could just go down the road.

20 comments on “Fingers burned”

  1. lukas 1

    Word is you are wrong… seriously, front up with your source or stop publishing rumors, it is amateurish at best.

  2. IrishBill 2

    lukas. Wrong like when? Like when I announced Act’s fifth list candidate for them? Or like when I pointed out National had ripped off Coldplay? Or when I predicted National would use court action as a PR tool to avoid the EFA? Or when I predicted National would mess with the employer-contribution element of KiwiSaver to pay for their Tax Cuts?

    I could go on but I think it’s pretty clear to all but the willfully stupid that my sources are sound and I certainly won’t be outing them. What is amateurish is thinking I would reveal any of my sources. Well, either amateurish or desperate.

    Then again it would be interesting to see what the results of an OIA request on the herceptin funding showed up. Perhaps you should file one.

  3. Who’s your source, lukas? How do you know he’s wrong?

  4. Tim Ellis 4

    Interesting story, IB. I don’t quite understand what “private specialists to administer the fund” means. Are you able to explain how this works and what the specific problem is?

  5. IrishBill 5

    Sorry about that Tim, a bit of a brain-freeze. The intended word was “treatment” I’ve changed that now.

  6. higherstandard 6

    Yes do tell IB – There are issues with a lack of oncologists and space in NZ oncology departments but your comment that “private specialists needed to administer the fund are going to cost a wee bit more than he expected.” is odd.

    Do you mean there is not enough capacity in certain DHBs in terms of clinical staff and ward space to administer Herceptin if this is what you’re implying it’s probably accurate although this has been known and openly discussed for some time and I don’t know why it’s any surprise to Ryall.

  7. IrishBill 7

    As I pointed out to Tim I misplaced a word. And as I understand it the surprise wasn’t the lack of public capacity but the expense of private treatment. This shows a lack of due diligence on the policy and the dangers of bypassing select committee.

  8. toad 8

    It also shows the stupidity of overriding the expertise of Pharmac in making and implementing what was an expedient election bribe designed to exploit public sympathy for breast cancer sufferers.

    And I say that as someone who lost my partner to breast cancer 9 years ago after nursing her through the terminal stages of her illness, so, please eveyone, don’t try accusing me of having no concern for the plight of those who suffer this dreadful disease.

  9. higherstandard 9

    Hmmmmmmmm

    Sounds a bit odd to me – if there’s no lack of public capacity why are the patients being treated in private ?

    This has all been discussed thoroughly during submissions to PHARMAC by the Cancer Specialists subcommittee it all does seem rather odd that you contact is suggesting that something has come out of left field that the Ministry was unaware of and that a select committee would have got additional information which wasn’t already on the table.

    Being a cynical chap I suspect someone or some department is trying to cover their arse.

    Edit

    Toad .. at the risk if repeating myself for the 97th time the medical experts who advise PHARMAC on cancer treatments supported the currently funded regimen.

  10. @ work 10

    Toad .. at the risk if repeating myself for the 97th time the medical experts who advise PHARMAC on cancer treatments supported the currently funded regimen.

    And to repeat myself for the 97th time, I’m sure they did. I’m sure the heart disease people support a bunch of new heart disease drugs too, and the STD people support a bunch of new STD drugs, and the eye people probably support a bunch of new eye drugs, and the mental health people probaby support a who bunch of mental health drugs. Its not the cancer experts job to over see all of PHARMAC’s spending.

  11. IrishBill 11

    HS, there is a lack of public capacity to provide treatment. Ryall knew this. What he didn’t know, according to my source, was how much the private sector was going to charge to pick that work up. It seems he didn’t figure it would be as expensive as it is. I assume that there wasn’t enough work done by National on the cost of the treatment before the policy was announced and/or written into legislation.

  12. toad 12

    Good reply @work – you beat me to it. Cheers.

  13. BLiP 13

    IrishBill said:

    ” . . . What he didn’t know, according to my source, was how much the private sector was going to charge to pick that work up. It seems he didn’t figure it would be as expensive as it is . . .”

    The greed of the the private health sector in its pursuit of profit from the misery of others took the minister by surprise? You are joking, right?

  14. higherstandard 14

    so @ work you’re now arguing against the guiding principle of international best practice as recommended by the medical experts that you were arguing for here ?

    Bureaucracy cutters call for more bureaucrats

    You also comment that “it’s not the cancer experts job to over see all of PHARMAC’s spending.”

    Quite so, it is however, their job to recommend which cancer medications should be funded and which is the best way to utilise them

    IB it seems the issue is whether the lack of public capacity was a surprise or not (I can assure you it should not have been) – if it wasn’t there’s no way that private provisioning costs would have come as any surprise to the Ministry or its advisors.

    All I can see here is more grist to the mill that the Minister, the Ministry – and its advisors are a pack of muppets.

    BLIP

    “The greed of the public health sector”

    Yes Yes quite right all Drs, Pharmacists, etc etc who have any type of private practice are thieves and rogues.

  15. toad 15

    higherstandard, if the National Party considered that PHARMAC’s decision re Herceptin was procedurally incorrect they could have instigated and funded a High Court challenge to it through judicial review long before the election.

    The Greens were considering doing the same re the PENLINK roading project approved by Annette King as Minister of Transport, just before the election but ran out of time – they may still do if National proposes to proceed with that project.

    The fact that neither the National Party, nor the pressure groups pushing for greater Herceptin funding, instigated judicial review proceedings would indicate that they saw nothing wrong with the procedure implemented by PHARMAC.

    Instead, National proposed to override the PHARMAC decision, which they have now done, and which I see as nothing less than cynical vote buying.

    Incidentally, the announcement of the decision prompted this delightful media release from PHARMAC:

    PHARMAC statement on Herceptin 12 month funding

    Press Release by PHARMAC at 10:57 am, 10 Dec 2008

    PHARMAC has played its part in the decision to fund 12 months Herceptin and will continue to assist the government as required.

    PHARMAC’s role has included providing information as necessary, and assisting the Ministry of Health with its contract negotiations with Roche, the supplier of Herceptin.

    PHARMAC fully respects the democratic process that has led to the Government’s decision to fund 12 month treatment with Herceptin.

    The nine-week treatment course will continue to be fully funded through the Pharmaceutical Schedule.

    Anyone spot the Tui ad?

  16. @ work 16

    You also comment that “it’s not the cancer experts job to over see all of PHARMAC’s spending.’

    Quite so, it is however, their job to recommend which cancer medications should be funded and which is the best way to utilise them

    They are operating with an absolute budget and choosing to spend it in the most cost effective manner. I’m sure theres other drugs than just the long course of herceptain they would like funded too. However the reccomendations recieved from other advisors, advising on other areas of health obviously put foward evidence that showed more people could be helped with a differnt drug in a different area that is more cost effective than the long course of herceptian.

    In other words, what medicines in your opinion should not be funded in order to fund herceptain?

    John key has not stepped in to fund it because of any errords on PHRMAC’s part, he’s funding it because a group of breast cancer suffers had a high profile campaign on the matter.

  17. Draco T Bastard 17

    What he didn’t know, according to my source, was how much the private sector was going to charge to pick that work up. It seems he didn’t figure it would be as expensive as it is.

    I suspect he was working on the illusion that Private Sector = Cheaper rather than the reality of Private Sector = More Expensive. If the doctors are paid the same, administration is the same and reinvestment is the same (all of which should be give or take minor technicalities) then the private sector will be more expensive because it has an added expense that the public sector doesn’t have – profit.

  18. higherstandard 18

    @work you seem to be mightily confused

    “In other words, what medicines in your opinion should not be funded in order to fund herceptin?”

    The funding for Herceptin has not come from PHARMAC’s budget.

    “However the reccomendations recieved from other advisors, advising on other areas of health obviously put foward evidence that showed more people could be helped with a different drug in a different area that is more cost effective than the long course of herceptin”

    What complete crap – the consultations regarding Herceptin were confined to which regimen should be funded and why. If consultations were open to where money should be spent in the health system we would revert to the same types of discussions that have occurred here.

    Bureaucracy cutters call for more bureaucrats

    I see you have also refused to give an opinion as to why you have taken two separate views in relation to your use of clinical best practice as the preferred approach to decision making.

    You also make the comment yet again that “…..Its not the cancer experts job to over see all of PHARMAC’s spending.”

    They didn’t they provided advice on a medication that is solely used in the area of their clinical expertise- PHARMAC chose to ignore that advice.

    I also don’t disagree with you or Toad on the fact that National funded it for a vote buying exercise this is however completely peripheral to the discussion I’m putting forward in relation to PHARMAC ignoring the advice of clinical experts.

    Read here for a view which I entirely agree with.

    http://www.nzma.org.nz/journal/120-1259/2676/content.pdf

  19. @ work 19

    “In other words, what medicines in your opinion should not be funded in order to fund herceptin?’

    The funding for Herceptin has not come from PHARMAC’s budget.

    Sorry I wasn’t clear there, I ment: If PHARMAC should be funding the full course of herceptain out of thier current budget, which medicine shouldn’t they fund in order to pay for that.

    I see you have also refused to give an opinion as to why you have taken two separate views in relation to your use of clinical best practice as the preferred approach to decision making.

    Well it would be nice to be able to fund the full course of herceptain, but the budget doesn’t allow for this. I considered it implicit that while trying to make decisions inline with clinical best practice that they should not over run thier budget.

    They didn’t they provided advice on a medication that is solely used in the area of their clinical expertise- PHARMAC chose to ignore that advice.

    Because PHARMAC must consider all areas of treatments, if they funded everything that ever section of advisors funded they would go over budget.

  20. snottynose 20

    Your source is wrong.

    Press release:

    Patients currently receiving a privately funded course of 12 months Herceptin now have the option of completing the remainder of their treatment with a public provider, where it will be fully funded by the Government. Women may choose to continue receiving treatment privately, although the Government will meet only the cost of the drug until they have completed their treatment. In this case, the costs of delivery will still have to be paid for privately. END

    Private delivery cost between Nov 19 and Dec 10 2008 will be reimbursed by the Govt. The costs of private delivery are well known since they were established during consultation.

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