I haven't read the article itself, but this seems to make no sense. To say that the small team of experts fund the treatments is misleading - they merely decide how existing resources should be redistributed.

For this scheme to work, funding would have to be taken from the Primary Health Care trusts and given to this centralised organization. This rehuffling does nothing to address scarcity of resources, and indeed could make the current situation worse by establishing another costly layer of bureaucracy to process and document claims and assessments. Furthermore, it does nothing to address the ethical issues involved in bypassing the existing method of testing and licensing medicines, possibly diverting resources from the provision of existing licensed medicines to those who can benefit from them.

Ultimately, the question of resource allocation and the organisation of health care is much larger than the Herceptin issue, or that of providing any given emerging medicine. Indeed, these are merely a few symptoms, examples, and special cases of a far more general problem involving funding and the question of provision. As such, any proposed method of dealing with such a narrow strand of the problem can't be taken to be anything more than a temporary 'patch' designed to appease popular demand more than address the fundamental questions and problems that need to be dealt with.

Secondly, although I'm a great fan of learning from debates and examples elsewhere in the world, I'm not sure that this is a case where such a method is truly applicable. After all, don't we already have the kind of largely centralised health care service that the article suggests is a solution to this particular problem?

The main thrust of the article was to put forward a possible reasonable solution to the situation where there is a post code lottery and patients who are denied what they consider to be a right i.e. treatment which is available elsewhere have to stay silent with the clear probability of dying or going to court to give them hope. The judicial system is costly and wasteful so this course of action is less than ideal.

Obviously this is only one of a number of options which is being discussed as a consequence of the scarcity of resources. You have highlighted correctly the ramifications but let us hope the problem can be resolved and if at any stage we on this Island face the same dilemmas, we at least will learn how not to deal with it.

There are many questions: such as why do pharmaceutical companies such as Roche put the price they do on NHS medicines? Should accountants make the decisions or doctors? Where is increased funding coming from? What is the cost to the country of a mother with a family losing her life and so it goes on.

We can all pose the questions. what are the answers?