THE National Institute for Clinical Excellence (Nice) is, in general, a good idea. It was formed by the Government to prevent the postcode lottery of treatment that was making the National Health Service anything but national.

However, as the Glivec case has shown, there are still problems with its working.

As Ann Tittley from Newton Aycliffe has shown, Nice is effectively creating a postcode lottery. While Nice is deciding whether a drug should be available on the NHS, it is left to local doctors and their seniors in finance departments to decide whether a patient should be prescribed the drug.

Understandably, investigations and consultations take time. But it has taken Nice a year to evaluate Glivec - a year in which the postcode lottery would have denied Mrs Tittley the drug to treat her cancer. She was fortunate in having the personal strength, in being a constituent of the Prime Minister and in having a powerful voice like that of The Northern Echo behind her, which together managed to the tip the lottery in her favour.

But, as the medical profession warned from the outset, if Nice is to play its role in modernising the NHS, it has to be given the resources to do its job speedily.

Closing ranks

THE Medical Protection Society (MPS) regards Richard Neale as a fit and proper person to work within the NHS. It believes that if a doctor were struck off for "falling below appropriate professional standards", it is alright to employ him in another medical field.

Mr Neale was found guilty of 34 counts of professional misconduct. He injured 200 patients in North Yorkshire and was also struck off in Canada after the death of one of his patients. In a recent interview, he compared himself to Princess Diana and Mother Teresa.

This catalogue is more than a simple mistake. It is a falling way, way below any appropriate professional standards. For the MPS to argue that a surgeon who falls so far below appropriate professional standards should be re-employed within the NHS does a grave disservice to those many thousands of dedicated people who work so tirelessly within the organisation.

It would also appear to be another example of the medical establishment closing ranks behind one of its own - and it is that closing of ranks that allowed the Neale and Harold Shipman scandals to drag on longer than they might otherwise have done.