Tuesday, 19 April 2011

Counting the costs of tobacco control

Let's go back to last October, and a reported entitled 'Government lobbying government', reported here. It gave the Scottish Government's grant to ASH Scotland as over £921,000 in 2008–2009.

This is a tabloid trick perhaps but one might ask how this situation arises, when ASH Scotland is guaranteed an income that would pay for the treatment discussed here for four people.

In the real world, of course, this is about rationing treatment. I have no idea what factors are built into decisions that allow some people funding for this kind of condition and not others. It is quite clear that the pot paying for drugs is not bottomless and hard decisions have to be made. The drug in question has not been approved by the Scottish Medical Council, but arrangements have been made successfully for at least one patient in Scotland to receive it.

SMC refused to approve eculizumab for use on the NHS last November. Professor Peter Hillmen is a consultant haematologist and expert on PNH, who leads the only Scottish clinic for patients with the condition as well as heading up a key treatment base for the illness in Leeds. He said: “I have two to three patients in Glasgow who are not funded. They are the only patients in the UK who do not have treatment.”
Negotiations are ongoing.

In the face of such stories it is hard to see how ASH Scotland's income is guaranteed, at a considerably higher rate than the London-based Action on Smoking and Health (see first link above), even though the population is only one-tenth the size of England's population. It has 27 staff to push its agenda (as I've pointed out before, when I was on a casual contract with the Scottish Government in a division of the Health Department dealing with illegal drug use there were just half a dozen of us plus secretarial backup shared with other divisions). 

Here's another waste of money: 620 delegates at c. £350 a pop (conference fee) plus accommodation expenses, attending a two-day conference on pushing smoking cessation drugs. Even the BMJ's Tobacco Control blog acknowledges that most people giving up successfully don't need the drugs, so why does so much money need to be thrown at this national obsession?

Incidentally I heard that the SNP have overtaken Labour in the polls –  perhaps the popularity of this story helps to account for it. Having discovered that enforcing a smoking ban in the grounds of several hundred hospitals is next to impossible they now want to try it in the grounds of a few million motor cars


Anonymous said...

ASH Scotland and their Alliances.


Eddie Douthwaite said...

"The formation of alliances and campaigning

2.24 In October 1999, the Scottish Cancer Coalition on Tobacco ( SCCOT) was created by ASH Scotland as an alliance between itself and the leading Scottish Cancer Charities and Scottish branches of UK Charities.

2.25 In 2000, ASH Scotland received funds from the Scottish Government to undertake a consultation process to explore the need for a national tobacco control alliance and the role(s) that it might hold. It then went on to form the Scottish Tobacco Control Alliance ( STCA) with Scottish Government funding, bringing together a multi-disciplinary, multi-sectoral body of over 120 organisations concerned with the impact of tobacco on Scotland and its people.

2.26 ASH Scotland set up Scotland CAN! (Cleaner Air Now) in May 2000. This brought together a wider group than SCCOT and began campaigning for legislation to restrict smoking in public places. In November 2004, it was agreed that SCCOT would no longer exist as a separate coalition, and that it would instead reform under the wider coalition of SCOT (the Scottish Coalition on Tobacco). Scotland CAN! also came under this umbrella."