Healthcare in the UK is mainly delivered via the state organised National Health Service. Most countries have an element of state funded healthcare but the UK is unusual in having a service which is free at the point of delivery. It is not "free" of course, as staff and material costs have to be met, but these are paid for by the tax payer so there is no barrier to patients approaching health services for emergency or routine treatment. This is a fantastic safety net and one that we in the UK are quite rightly proud of. Health is a basic right and in developing a system that embodies this, we have done our nation proud.

Over the past decade there has been an understandable move towards protecting the tax payers investment in the NHS by striving to ensure that all treatments, where possible, are based on a sound evidence base. This "Evidence Based Medicine" is commendable but does make it difficult to introduce any new innovative treatments within the NHS. Each Health Board has a committee looking at the evidence for each treatment particularly new treatments and ideas.

Where does this leave CCSVI?

In the UK, unlike Canada and a few others, there is also a small but vibrant private health sector. It is often in this area that new ideas are introduced and tested before becoming a standard NHS treatment, theoretically available to all. There is no doubt that this is where CCSVI belongs, but it is not easy to make the transition to standard treatment. Commissioners of care are persuaded by evidence so the onus is on collecting and publishing evidence of treatment effectiveness.
As the torch carriers for CCSVI in the UK, we at Essential Health Clinic (EHC) are aware of the responsibility we have to ensure the benefits of CCSVI treatment are recording in the correct manner. We are fully engaged in this process and will communicate further details of this in the near future.

There is an opportunity to push for the inclusion of CCSVI as standard treatment within the NHS in the next two years. In England and Wales in 2013, the role of commissioning services is to be devolved down to General Practitioners (GP's). This is a massive shift of power and it is likely that these GP commissioning groups will be more open to new and innovative treatments. We have two years therefore to work flat out to produce as much evidence both locally and internationally to convince these new commissioners that CCSVI is a good buy. Local lobbying of these commissioners will be important but to back this up we need evidence and data of objective measures of improvement such as MRI changes.

It is currently possible for patients to demand that their NHS treatment takes place in the private sector providing the cost is no greater than NHS costs. Costs are often comparable in the private sector which can be more efficient with less senior management and administrative staff.

In 2010 over 200,000 patients were treated in the private sector but paid for by the NHS. In the case of new treatment procedures such as screening and angioplasty for CCSVI, the inclusion of staff training is likely to make it more cost effective for this treatment to be carried out by an experienced private organisation such as EHC.

We at EHC aim to be the main providers of CCSVI treatment to the NHS from 2013. To achieve this we need to provide sufficient evidence to convince the new GP commissioners that CCSVI treatment will produce real improvements in MS and other conditions. Everyone in the MS community needs to work together to achieve this aim which will be a huge breakthrough for both CCSVI and MS in the UK.

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