Cancer doctors say drugs system is unfit for purpose
Senior doctors involved in the treatment of cancer patients have said many of them are not getting the drugs they need.
Members of the Beatson Oncology Centre Consultant Committee have written to the Scottish parliament's health committee about the issue.
They said the system is "inflexible, opaque and unfit for purpose".
The health secretary Alex Neil has said all patients should have access to drugs which would benefit them.
Doctors at the Beatson, based in Glasgow, provide specialist care for more than half of cancer patients in Scotland.
The rules on specialist drugs for patients with rare conditions are undergoing change in preparation for the introduction of an all-new system in April.
The letter from the consultants said: "We appreciate that access to these valuable but costly drugs is a complex issue.
"We are concerned that despite the suggestions from Scottish government that the system of application requesting use of these medicines is now less restrictive and access to these drugs is more open, our local experience is that the system remains inflexible, opaque and unfit for purpose.
"It continues to give the impression that a process exists to allow patients with serious health issues access to these drugs, when in fact this is plainly not true."
The letter suggested that specialist drugs are more readily available elsewhere in Scotland.
It added: "The existence of postcode prescribing within Scotland adds to the injustice experienced by our patients."
MSP Duncan McNeil, the convener of Holyrood's health committee, said: "Announcements were made in December that we were moving to a new system.
"The issues that arise from the transition were dealt with in December when the cabinet secretary for health assured the parliament and committee that those people who were caught on the transition would be dealt with more sympathetically so they wouldn't lose out.
"The consultants are saying there has been no change. In the transition we have failed that test up to now but I'm sure that the committee and the Scottish government will be working hard to put that right."
He added: "Time is of the essence. We are dealing with people with very rare and indeed end-of-life conditions."
Health secretary Alex Neil said: "The new system comes in entirely next month, in April.
"I don't see any reason whatsoever why we can't have a system in Glasgow, as we have in the rest of the country, where the very flexible approach is taken.
"If a patient would benefit from a particular cancer drug... if the clinical view is that the patient would benefit from that particular drug, then the patient should get that drug."
NHS Greater Glasgow and Clyde has defended the procedures it has in place.
A statement said: "We are anticipating formal guidance from the Scottish government on the establishment of the new national Peer Approved Clinical System (PACS) arrangements.
"During the interim transition period all boards were asked by the chief medical officer to put in place interim policies to exercise flexibility in relation to decision making within the existing Individual Patient Treatment Request (IPTR).
"Our interim policy - which was consulted on at local, regional and national level - is very much in line with the spirit of the revised arrangements which are due to be implemented later this year, and incorporates peer review, clinician involvement and clinical influence on decision making."