More than half of Wales’ 22 local health boards underspent their drug prescribing budgets by over £34 million during a two–year period, a new study has revealed.

The research, conducted for the Association of the British Pharmaceutical Industry in Wales (ABPI Cymru), found that the LHBs underspent their prescription drug budget by more than £20 million overall in 2005-6 and by over £14 million again the following year.

Critics claim that the savings have been used to the pay the Boards’ debts in other areas, and that the policy is denying Welsh patients access to the most effective new drug treatments. Welsh Conservative health spokesman Jonathan Morgan, who will lead a debate in the National Assembly calling for all Welsh patients to have access to drugs to treat wet age-related macular degeneration this Wednesday (June 25), said the savings were “clearly unacceptable” at a time when “so many LHBs are struggling to fund the new drugs coning on-stream.” The Royal National Institute for the Blind in Wales has condemned the provision of drugs to treat wet AMD in Wales as a “postcode lottery.”

And Welsh Liberal Democrat health spokeswoman Jenny Randerson pointed out that if the Boards had spent up to the levels of their budgets, “we would have fewer cases of people being denied the best, most effective modern drugs.”

The findings were described as “disappointing” by ABPI Cymru director Dr Richard Greville, who said that medicines “often make a dramatic, positive impact on the quality and lives of patients and carers, while saving other NHS and wider societal costs.”

“The stark reality is that Wales and the UK in general has among the lowest uptake and use of new, innovative medicines in Europe, while suffering some of the poorest health outcomes,” he added.

In its recent assessment of Designed for Life, the 10-year strategy for NHS Wales, the National Leadership and Innovation Agency for Health Care (NLIAHC) reported that all LHBs in Wales are now achieving the 78% national generic prescribing target, with some achieving almost 85%.

More attacks on Welsh NHS budget moves
Also this month, the Public Service Ombudsman for Wales has, for the third time in less than nine months, slammed National Health Service bodies for “failing to provide patients in Wales with the service they need because they are trying to protect their own individual budgets.”

The Ombudsman, Peter Tyndall, has criticized Cardiff and Vale NHS Trust and Cardiff Local Health Board after a pregnant woman was told by her local hospital that she would not be offered a routine antenatal anti-D prophylactic injection, even though the National Institute for Health and Clinical Excellence has recommended its use.

The two other cases, which criticized Health Commission Wales, Bro Morgannwg NHS Trust, Cardiff and Vale NHS Trust and Vale of Glamorgan LHB for failing to provide patients with equipment which they needed, appear in the Public Services Ombusdman’s recently-published report for 2007-8.

“It is unacceptable for patients to be denied access to the most appropriate treatment or equipment to which they are entitled simply because the different NHS bodies involved in the patient’s care are trying to protect their own individual budgets. Members of the public are entitled to expect that the NHS in Wales will put patients first and act to deliver an effectively co-ordinated NHS,” said Mr Tyndall.

Yet another report this month has concluded that HCW, which was established as an Executive Agency of the Welsh Assembly Government in 2003 with a remit to commission specialised healthcare services which are not provided by NHS Trusts or LHBs, falls short of its fitness for purpose and should be replaced.

Fundamental flaws in the way the Commission was established, poor governance arrangements and an unsound budget allocation has led to confusion and “left some patients paying the price,” says the review, which was conducted by the Wales Centre for Health at the request of Welsh Health Minister Edwina Hart.

Commenting on the study, the Welsh Tories’ Jonathan Morgan said that HCW has “appeared to act as a barrier to modern medicines, rather that one which allowed patients to access the latest treatments to aid their recovery.”