“From next April, when the National Insurance increase that Labour are proposing would have been applied to the NHS as an employer is not going to be applied, that will save the NHS from next April £200m and that money we will make available to meet the cost of new cancer drugs.”
Andrew Lansley, Shadow Health Secretary, speaking on BBC’s Today programme, 5 April 2010
The Conservatives say that by not implementing the proposed rise in Employers National Insurance Contributions for NHS staff they would save the NHS at least £200m a year. This would be used to create a Cancer Drugs Fund. The Tories claim it would give every patient access to any cancer drug their doctors says they need, so long as the drug has been licenced since 2005.
Currently, the National Institute for Health and Clinical Excellence (NICE) issues guidance to the NHS on what drugs can be supplied to patients under their “quality-adjusted life years” measurement which focuses “on treatments that improve the quality and/or length of someone’s life and, at the same time, are an effective use of NHS resources”.
The published guideance often results in controversial decisions on what cancer drugs can be supplied and to whom.
Under the Tory proposals NICE could be bypassed when approving cancer drug funding until 2014, when the Conservatives would introduce a reform of the whole NHS drugs pricing policy.
So, is the £200m real money? And would £200m cover the extra cost of making any cancer drug treatment available?
It has been claimed that the £200m is not money that the NHS already has – but rather money it doesn’t have to find to fund a rise in National Insurance – and that therefore it does not exist.
John Appleby, chief economist at the King’s Fund – a highly respected charity that influences healthcare policy – described the Tory statement as a “sleight of hand“.
Mr Lansley responded: “Contrary to what John Appleby has said, we have been very clear we are going to protect the NHS budget, we are going to increase the budget each year in real terms, so within that budget from next year onwards the employers in the NHS don’t have to spend £200 million-plus on an increase in National Insurance, they will have that money available to meet other needs.”
The King’s Fund later put out a statement saying that they did not want to suggest there was “anything dishonest about the Conservative proposals to fund cancer drugs”.
But the organisation remains of the view that as the National Insurance increase “has not yet been implemented and given other pressures on the NHS budget the £200m funding would need to be generated by planned cash-releasing efficiency savings.”
Health economist Zack Cooper from the London School of Economics told FactCheck:
“The challenge [for the Conservatives] is to say, with specificity, from where they’ll get the money to pay for the policy…. Every party comes to power saying ‘we’re going to take our hands off the NHS’. But it doesn’t mix well with politics. When it comes to drugs and closing hospitals it is very hard to step away. That’s precisely why groups like NICE rely on using peer-reviewed evidence to form their decisions and are not political bodies.”
He added: “No-one has been specific about whether or not the money is there. This isn’t money sitting around that Labour decided not to spend. In short, is the £200m just sitting there? No. Is it easily obtained? Yes.”
So the money could be found but is £200m enough?
A leading cancer charity told FactCheck that it wasn’t possible to say for certain that £200m would cover the added cost of funding for all cancer drugs.
However, in the past year NICE has tended to reject drugs used to treat rarer cancers and, as the number of patients affected by rarer cancers is small, it’s not unreasonable to suggest that £200m annually would be enough.
Like the King’s Fund, we find there is nothing to suggest “anything dishonest” in the Tory proposals.
However, at the moment the £200m to fund it is being paid for by the abolition of a tax which has yet to be implemented so the money does not yet exist in real terms.
And, as £200m is a relatively small sum in an NHS budget of over £100bn, it is not unreasonable to assume that it is achievable but we’re unlikely to get the full details on funding this side of the election.