So according to all yesterday’s media — see for example the Guardian and the BBC — we patients need to be much more pushy with our GPs to get the best drugs.

Prof. David Haslam, chairman of the National Institute of Health and Care Excellence (NICE) and himself a former GP, said that patients need to see themselves as “equal partners” with doctors to get the treatment they need.
He went on to say that patients should demand the drugs they need and only be refused NICE-approved drugs if they are actually unsuitable. He says, inter alia:

When products have been approved for use by the NHS by Nice, patients have a legal right to those drugs — as long as they are clinically appropriate. The take-up should be much higher than it currently is.
Patients have a right under the NHS constitution to these therapies, so I really hope we can improve this.
The fundamental point is, it’s your body.
And the more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor.

Several things strike me about this.
Firstly, I cannot disagree with Prof. Haslam’s sentiments. There are drugs which people aren’t getting, for all sorts of reasons including the so-called “postcode lottery” of care provision.
And I applaud his stance that we take responsibility for our bodies, understand them and how they work. This has to be good — as regular readers will know I am a vocal advocate of being comfortable with, and talking about your body, as a route to improved medical care.
But there are several things which worry me here.
We have to be realistic and accept that, sadly, many people are not able to understand even the rudiments of how human physiology works and how drugs work. Unfortunately these are mostly the very people who are going to latch onto some drug/treatment they think they should have and be abusive with their GP when they aren’t given it. Doctors are already under enough pressure, and get enough abuse from patients, that they don’t need more.
And then there are the people who really don’t want to think about these things and want to just trust their doctor to give them the best treatment. Not everyone, regardless of intellectual capability, wants to be engaged in the way Prof. Haslam would like. Yes there is still too much of the doctor as demigod who knows best, but there will always be those who treat any professional this way.
Finally I worry about who will pay for all this. I wouldn’t mind betting that many of the drugs we should be demanding are more expensive than the ones we are being prescribed now. So Prof. Haslam’s approach is going to see the NHS drugs bill increase, perhaps dramatically. You watch in a year or so the NHS will be squealing because the drugs budget is out of control.
But perhaps the biggest problem is how we patients actually find out about which drugs are best for us. I reckon I’m pretty good at ferreting out information and have research skills, but even I find it hard to sort the wheat from the chaff when it comes to drugs — especially when so much drug trial data has never been published.