Mills & Reeve recently acted for West Sussex PCT in relation to yet another challenge to a decision not to fund an unapproved cancer treatment, R (on the application of Ross) v West Sussex PCT.
In short the judgment went in favour of the patient and the judge made the following observations:
- he felt that the PCT had failed to appreciate the importance of expert evidence when considering whether or not to fund a treatment;
- that although the PCT in principle could have a policy which refused funding except in exceptional cases, he found the policy defined exceptionality in terms which did not allow for a group of patients to be regarded as exceptional, that he felt the relevant section in the policy was over complicated; and
- where exceptionality is made out, particularly where matters extending life is concerned, a PCT should take a less restrictive approach to cost effectiveness than when considering the case for funding a drug as part of its operational plan.
This was a decision of a deputy High Court judge and so is not binding, however, it would be unwise not to take account of his observations.