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Lucentis

I will check on that. I believe that the strategic health authority confirmed that Miss Y had not paid for Lucentis but had paid for Avastin. The guidance advises NHS organisations that until NICE has published final guidance on a treatment, they should continue with local arrangements for introducing new technologies, based on an assessment of the available evidence. The guidance also identifies potential sources of information to help PCTs to make such assessments. When the local NHS decides not to fund a treatment, the patient and the clinician can expect an explanation. To underpin that, the Government will require PCTs to establish clear and very transparent arrangements both for local decision making on the funding of new drugs and for consideration of exceptional funding requests, and to publish information on those arrangements. That is laid down in the draft constitution which we published last week. Lucentis and Macugen are licensed treatments for wet age-related macular degeneration. Doctors can prescribe Macugen or Lucentis in advance of NICE guidance if they believe that it is the right treatment for their patients, subject to funding from the PCT. When Lucentis was licensed in January 2007, services for people in West Kent with wet age-related macular degeneration were commissioned by the south east coast specialised commissioning group. To ensure equitable access for all patients on the south-east coast, the group commissioned the local health policy support unit's policy recommendation committee to give guidance to commissioners on the most cost-effective delivery. Owing to the significant differences between preliminary NICE guidance issued for consultation in June 2007 and the policy recommendation committee's guidance, a review of both guidelines was undertaken by the south east coast specialised commissioning group. The group recommended the use of Lucentis rather than Macugen, while maintaining the previous eligibility criteria. In the last few minutes of my speech, I want to concentrate on the right hon. Lady's constituents, Mr. X and Miss Y. I am totally sympathetic to the concerns that the right hon. Lady has raised about those two specific cases. I have been assured by South East Coast strategic health authority that such cases are considered by individual treatment panels, which always have at least one member who is a clinician. Each case is considered on its merits, and without setting precedents for future claims. Treatments may be inside or outside the national health service. Individual treatment panels were established in West Kent in consultation with all health community partners, primarily to consider funding for treatments for named individuals owing to their exceptional clinical circumstances and exceptions for treatments excluded by the PCT's clinical policies. West Kent PCT confirmed today that the individual treatment panel would reconsider the case of the constituent referred to as Miss Y, and would write to her and her consultant once the panel had reached a decision. I am exceptionally sorry that Miss Y has had to go through this trauma, which must have been very stressful for someone such as the lady whom the right hon. Lady has described. I am grateful to the right hon. Lady for raising the case with me; I am only sorry that she had to do so in this way. In the case of Mr. X, I have this afternoon been reassured by South East Coast SHA that it will ensure that Mr. X has the opportunity now to meet with the PCT decision makers and his specialist so that they can explain the rationale for the decision. It will also ensure that a specialist provides reassurance about the recommended treatment for his condition. I am led to believe that there is concern about the recommended treatment for the condition. Therefore, I would expect any patient to be reassured and to have a lot of support and guidance about possible future treatment, and not, of course, to receive a letter. I understand West Kent PCT's position is that while it is sympathetic to the distress and anxiety of people within its area, it cannot fund an unlicensed and unapproved treatment when an effective and nationally recognised alternative for a condition is available, but the management of such communication is essential and I would have expected better from today's NHS. West Kent PCT, like every PCT, has a duty to ensure that best possible use is made of taxpayers' money to meet the health needs of its whole population. Decisions about individual cases must be based on all available evidence. The right hon. Lady would respect such decisions. It is the management of decision making that has caused distress to a young man with a young family. I hope that I have been able to set out the importance of having a properly evidence-based approach to the introduction of new treatments, but how we communicate about new treatments and their management is important. If at any time the right hon. Lady feels that Mr. X and Miss Y are not receiving what I have stated tonight, I will willingly meet with her and take an interest in both cases. I wish both of her constituents well with their future treatment. Question put and agreed to.