On the Politics Show, Sunday 20 January 2008, Jon Sopel interviewed Professor Roger Boyle.
JON SOPEL: The government's Heart Czar, Professor Roger Boyle joins us here in the studio. Welcome to the Politics Show. Why is it that there are so many Trusts still effectively wasting millions of pounds each year?
PROF ROGER BOYLE: Well, as you heard in your excellent piece, up until just over three years ago, the villain in the piece, the most expensive statin at the moment, Atorvastatin, was the best buy and many GPs busily switched their patients from the other statins, to these more expensive items. Now the boot is very much on the other foot and we have to ask them to switch the patients back and so this is a big labour intensive task.
JON SOPEL: I suppose I ought to declare a slight vested interest here, but I mean it's hard to tell a patient, if they've been prescribed one drug, to suddenly go on to another when you've got used to one that's given you no side effects.
PROF ROGER BOYLE: Exactly and I take Simvastatin, but I've been on it all along. If I was on another one and was asked to switch for the sake of the Nation and save a few bob, then it's a difficult debate to have and remember that this is a huge industry not just for the pharma companies, but actually for the GPs; eleven million scripts written out every quarter, forty four million prescriptions written out by GPs every year, each one a sort of individual interaction, which has to be individualized to the individual taking the tablet.
JON SOPEL: It seems to me there are two levels on this: how much force should a GP have over a patient, to tell the patient what to prescribe.
PROF ROGER BOYLE: Yeah.
JON SOPEL: And the second level is whether central government has the right to tell the local Primary Care Trust what to do; so on the patient one, should a Doctor just be able to say, I'm sorry, I'm changing your drugs.
PROF ROGER BOYLE: I don't think so, no. And we do know that probably, it's a, it's a debated point but maybe one in six people would need the more expensive ones either because the, they were the only ones effective for them or because they've had side-effects with the cheaper ones, so there's always going to be a number of patients who would always warranting having the more expensive drug. Our challenge is to reduce that number to a bare minimum.
JON SOPEL: Okay, and what about on that other level, that Central Government, you, being able to say to Primary Care Trusts, right, these are your targets, you've got to hit them.
PROF ROGER BOYLE: Well we do have a project which is called Better Care, Better Value, which has been set some indicators as sort of bench marks for Primary Care Trusts to aim that but they're not mandated targets. I don't think Edward Leigh's view is that you can just sack the staff that are failing to achieve this. We have to remember that the use of these drugs, as they are at the moment is making a huge impact on the health of the nation. You know, nearly a 5% reduction in deaths from circulatory diseases every year.
JON SOPEL: And what about mass medication as a solution to this; we put fluoride in the water because we believe it has beneficial health effects, I'm not suggesting you put statins in the water but why not say, right, we're going to aim as they are indeed doing in Scotland, to say right, 50% of men over forty, we want you to be on statins.
PROF ROGER BOYLE: Well, you will have heard the Prime Minister's speech on Health back on the 7th January, where he really muted this idea that we need to move in to a more of a (interjection)
JON SOPEL: Pre-emptive phase.
PROF ROGER BOYLE: pre-emptive phase and that is exactly the policy we are developing at the moment in the Department of Health.
JON SOPEL: Okay, well what could that mean.
PROF ROGER BOYLE: Well, it needs, it can't just be about tablets you know, statins and reducing blood pressure, it's got to be combined very much with the life style issues as well; so that means that you can't just do it on a blanket approach across the country, you've got to do an individual risk assessment and have a discussion with the individuals, as to what their choice is, in terms of their own life styles and make it easy for them to choose the healthy choices, and also introduce the notion that maybe a tablet for their cholesterol and reduction in their blood pressure, would also be helpful.
JON SOPEL: Okay, Professor Boyle, thank you very much indeed for being with us, very interesting.
PRFOESSOR ROGER BOYLE: Thank you.
END OF INTERVIEW WITH PROF ROGER BOYLE
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The Politics Show Sunday 20 January 2008 at 12:00 GMT on BBC One.
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