I am personally familiar with the horrors of Alzheimer’s disease, which my mother suffered from. There were early warning signs: a woman who once tended to her house plants lovingly no longer thought to water them, hardly noticing their wilting. Eventually, she had not a clue that she had once been married and widowed.
Forgetting something now and then – a name, where you put your car keys, even your grandchild’s birthday – is entirely normal as we get older. But doing something such as cooking a meal, taking the peas out of the freezer, and then pouring them straight on to the plate to accompany your lunch should definitely be taken as an indication that all is not well.
How I longed for a way to halt the cruel, inexorable toll of the illness. So I felt jubilation when I read that a new drug to slow down Alzheimer’s – the disease that accounts for up to 80 per cent of dementia cases – was about to receive official approval for use in Britain. But that rejoicing turned to dismay when it was announced that the drug lecanemab, despite being approved for use by the medical regulatory body, would not be available on the NHS.
Trials have shown major improvements for those in the earliest stages of the disease, and around 70,000 patients in the country might benefit from the new drug. But the health watchdog Nice says it cannot justify the cost to the NHS of around £30,000 a year for each patient. Meanwhile, patients who can afford it will be able to acquire it from private hospitals and clinics as early as October.
This approach to healthcare – you can have it only if you can afford to pay for it – would surely have Nye Bevan, founder of the NHS, turning in his grave. As he once put it: “No society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means.” Now the service is rejecting that philosophy outright, all in the name of saving money.
Of course, it is not just about actual cash, but the financial choices made by those in power. For instance, the Chancellor Rachel Reeves has limited the winter fuel allowance to those living on less than £12,600 a year, claiming that it is necessary to balance the budget. Yet there is apparently enough in the Treasury coffers for a junior doctors’ pay deal that could see salaries rise by a whopping 22.3 per cent over two years.
The same choice applies to which diseases the NHS chooses to treat. The service spends around £6.5 billion each year on obesity-related expenses, with an obese patient costing twice as much to treat as a healthy one. Expensive surgeries like gastric bypasses are not withheld from the morbidly overweight. So why is a drug that could transform elderly lives neglected?
There are others who will be affected by the decision to block the use of this new Alzheimer’s treatment. The cost of dementia affects not just those suffering cognitive decline, but their families, too – something that any cost-benefit analysis of lecanemab ought to have been fully taken into consideration. Consider the people who have to stop work or cut their hours in order to look after elderly parents. Then there’s the emotional toll and the exhaustion that families endure, as I know so well.
Although helped by part-time carers to look after my mother before she went into a nursing home, I was still up at 5.30am each day cooking meals for them to reheat while I held down a full-time job as a magazine editor. It is lonely enough caring for someone with dementia, and is no doubt even more difficult to suffer from it yourself. Old age is a time when, after paying taxes and making National Insurance contributions all your working life, you need to feel that the Government is on your side.
Yet the waits for cataract operations and hip replacements remain long. The winter fuel allowance is no longer universal. And a drug to ease the crushing burden of Alzheimer’s is being stymied. The elderly are way down the Starmerite pecking order.