#PoliticalSpeak: in memory of AA Gill

AA Gill (1954-2016) died yesterday; could he have lived another 10 years? #PoliticalSpeak #MSBlog

It is always sad when a person dies young. AA Gill a renowned UK food critic and journalist died yesterday, with what I assume was small cell lung cancer. For Londoner's he made and destroyed restaurants with his acerbic wit and ruthless critiques. Just before his death AA Gill penned his last article on the good, the bad and the ugly of the NHS. AA Gill did not have private medical insurance and therefore was unable to top-up his cancer treatment. His consultant wanted to use an immunotherapy that is not available under the NHS.  The therapy in question is a relatively new, innovative immunotherapy, called Nivolumab, that can result in dramatic responses in some people with small cell lung cancer. Nivolumab at £60,000-£100,000 a year for lung cancer is simply too expensive for the NHS. The article highlights the 'elephant(s) in the room'; the poorer survival rates of cancer in the UK compared to other EU countries. Is this acceptable? I have little doubt that when we get a league table on MS outcomes we will also be floundering at the bottom of the league tables. With the NHS in crisis and outcomes falling is it not time for the British public to look in the mirror and ask themselves the question 'Is this good enough?'. Do we want rationing? Do we want to a two-tiered healthcare system with the 'haves' and the 'have-nots' (AA Gill included)? 

With cancer the outcome is usually black-and-white; alive or dead. With MS the outcomes are more nuanced; from normal, to independent, semi-independent, dependent and dead. The issue of access to DMTs is very pertinent as the MS special interest group of the ABN meets tomorrow to help NHS England draw-up new guidelines about the treatment of MS in England and Wales. What cap will  the ABN be asked to wear? In my opinion it is essential that we represent our patients; we are neurologists that look after pwMS. The ABN has to take on the role of patient-advocate; it is not our role to enforce NHS policy, but to fight, based on the evidence, for the best outcomes for our patients. How many more AA Gill stories do we need to hear? 


AA Gill: “More life with your kids, more life with your friends, more life spent on earth — but only if you pay”. The Sunday Times December 11 2016, 12:01am, 

........ It seems unlikely, uncharacteristic, so un-“us” to have settled on sickness and bed rest as the votive altar and cornerstone of national politics. But there it is: every election, the National Health Service is the thermometer and the crutch of governments. The NHS represents everything we think is best about us. Everyone standing for whatever political persuasion has to lay a sterilised hand on an A&E revolving door and swear that the collective cradle-to-crematorium health service will be cherished on their watch.....

CoI: multiple

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