Public Petitions Committee investigates NHS availability of cancer treatment drugs


Availability of cancer treatment drugs on the NHS has been announced today as the subject of an inquiry by the Public Petitions Committee. This follows the Committee’s initial consideration of a petition from Tina McGeever on the provision of a cancer treatment drug to her husband Mike Gray.

The role of the Public Petitions Committee is to investigate each admissible petition. Consideration of this petition has raised particular issues which the Committee has agreed to look into, including:

  • the roles played by various agencies in assessing whether a cancer treatment drug is made available on the NHS
  • whether there are any anomalies in the prescribing regime
  • the guidance available to clinicians and the relationship between private and public funding of treatment
  • whether there is parity with other life threatening conditions in terms of drug availability and treatment

Committee Convener Frank McAveety MSP said—

“We hope to bring clarity and assistance to those cancer sufferers who may have experienced similar issues to those faced by Mr Gray. We would like to invite written evidence with a view to taking forward oral evidence hearings in April and reporting before the summer recess.”

Inquiry Remit

The Committee has agreed that its inquiry remit will be—

‘An inquiry into the provision, on the NHS, of cancer treatment drugs and whether there is equity across NHS boards of the appropriateness, effectiveness and availability of such drugs and whether there is parity between the cancer drug treatment regime and other life threatening or other terminal conditions.’

The inquiry will not look into the availability on the NHS of other drugs. The Committee considers such an inquiry would likely take it outwith the terms of the petition and into more wide ranging matters perhaps more appropriate for the Health and Sport Committee. Therefore, to assist those engaging with the Committee, it has produced a series of questions and issues it hopes will act as parameters for the inquiry. These are—

  • Whether the roles fulfilled by local area drug and therapeutic committees, the Scottish Medicines Consortium, NHS Quality Improvement Scotland and the National Institute for Health and Clinical Excellence are clearly defined when undertaking clinical, scientific and cost-effectiveness assessment on the use of cancer treatment drugs and the guidance that is subsequently issued to NHS Boards and clinicians?
  • In terms of the number and roles that these bodies play—
    • do any anomalies or contradictions exist and is there any duplication of roles?
    • are resources being used constructively and efficiently and are there inefficiencies as a result of all these bodies?
    • how is effective communication maintained across and amongst these bodies?
  • Do any anomalies exist in terms of the roles played by these bodies when considering drug treatments for other life threatening and terminal conditions and how can such anomalies be resolved?
  • What action and steps need to be taken to streamline the roles played by these bodies and the processes involved and why are these not being taken?
  • What requirement is there for an NHS Board to adhere to advice and guidance issued by the Scottish Medicines Consortium and NHS Quality Improvement Scotland (which recommends NICE guidance to the NHS in Scotland and which supersedes SMC guidance) on the approval and use of cancer treatment drugs?
  • Is implementation of guidance across NHS Boards variable and if so, what checks and balances are in place to address this?
  • What assessment is done of how individual clinicians apply such guidance?
  • Do any anomalies exist in terms of the implementation of guidance on cancer treatment drugs and guidance on drug treatments for other life threatening or terminal illnesses and how can such anomalies be resolved?
  • What views and suggestions have been offered by (a) clinicians and (b) patients on the procedures involved in making cancer treatment drugs available?
  • Whether there are any cancer treatment drugs available in some NHS Boards but not in others?
  • What criteria are applied by NHS Boards when considering whether to fund a cancer treatment drug not recommended by the SMC?
  • What are the conditions and criteria set by NHS Boards to use ‘exceptional prescribing circumstances’ and is any guidance provided to patients?
  • Whether it is ethical and appropriate that patients should self-fund and prove the merit of being prescribed a particular drug and to what extent does ECHR apply in the decision making process when a NHS Board is considering a funding request?
  • What is the reasoning behind the position whereby a person cannot be treated as a private patient and a NHS patient for one condition during a single visit to an NHS organisation?
  • Does the availability of cancer treatment drugs across NHS Boards fit in with the Scottish Government’s cancer strategy and are there any contradictions between availability and the overarching policy?
  • Are there any particularly unique issues or considerations that apply in terms of the availability on the NHS of cancer treatment drugs that do not apply in relation to other drugs for terminal illnesses?
  • The criteria and basis of the formula used to measure both the quality and the quantity of life lived, as a means of quantifying in the benefit of a medical intervention (Qalys)
  • What consideration is being given to the availability of cancer treatment drugs as part of the Scottish Government’s national discussion on the future of cancer care?


The Committee previous consideration of petition PE1108 took place on 15 January and 19 February. The Minutes recording the decisions of the Committee at its meeting on 4 March are available via the Committee’s webpage.

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