18.39R (Otley) v Barking and Dagenham NHS PCT [2007] EWHC 1927 (Admin), (2007) 10 CCLR 628
The reasons for declining to fund cancer treatment, in this case, were irrational
Facts: Ms Otley suffered from metastatic colorectal cancer and sought treatment with Avastin, supported by her consultant Barking and Dagenham’s panel declined to make provision, on the basis that it had not been recommended by NICE and the circumstances were not exceptional.
Judgment: Mitting J held that while Barking and Dagenham’s policy had been rational, its decision-making had not been:
26. I approach my task on a very conventional basis. The question which I have to ask is whether or not the reasoning and decision of the Panel was rational and so lawful on Wednesbury grounds. I have identified already respects in which in my view the decision of this panel was not rational. I summarise them in headline form. First, Dr Sharma’s query about the ratio in which Avastin had been prescribed by comparison with other components of the cocktail was an irrelevant query. Secondly, there were no other treatments in practice available to Ms Otley amongst those that could be prescribed within normal National Health Service standards which were likely to have any benefit for her. Thirdly, the Panel did not take into account the slim but important chance that treatment including Avastin could prolong Ms Otley’s life by more than a few months. Fourthly, on any fair minded view of the exceptionality criteria identified in the critical analysis document, her case was exceptional.