Slimming surgery on the NHS

Slimming surgery is to be made available on the NHS - at a cost of £5,300 per patient.

As a result, by 2010 the NHS will be faced with an annual bill of £21million to treat up to 4,000 people who are chronically overweight.

But the announcement has caused outrage among cancer sufferers who only last week learned that use of Glivec, a revolutionary new drug in the fight against leukaemia, is to be restricted.

Both decisions were made by The National Institute for Clinical Excellence (Nice), which determines which treatments the health service should offer.

There are fears that Nice's panel of experts are basing their recommendations more on cost than on how clinically effective certain drugs and treatments are.

Nice has defended its position, saying that the slimming surgery represents value for money and could save thousands of obese people from dying prematurely of heart attacks, strokes, diabetes and other diseases.

At present, only 200 NHS patients a year have the surgery, although some 600,000 people are classed as seriously obese.

Nice has recommended that within the next eight years there should be a 10-fold increase in the number of chronically obese people who undergo surgery to correct their condition.

The procedure involves either bypassing part of the digestive tract, limiting food absorption, or "restrictive" surgery, with tight bands placed around the stomach so that people feel full after eating less food.

But it is the tandem announcements that have caused such uproar among cancer patients.

Trials of Glivec have shown that it can eradicate chronic myeloid leukaemia (CML) in seven out of 10 sufferers, compared with a cure rate of just 11 per cent with conventional chemotherapy.

More than 3,000 people in Britain are living with the disease or are newly diagnosed every year. Around half do not survive for more than five years after diagnosis.

But Nice has decreed that Glivec, which costs £18,000 a year, should only be used for those with advanced CML, denying it to thousands of other patients who are at an earlier stage of the disease.

Nice says that the drug is neither cost efficient nor clinically effective, even though doctors in the US were so amazed by its success that it was licensed for use there in record time.

Professor John Goldman, leukaemia specialist at the Hammersmith Hospital, has said that Nice's decision goes against the near unanimous body of medical opinion, and has described the decision as "profoundly illogical and grotesque".

And Professor Tony Goldstone, director of the North London Cancer Network, said that Nice's decision would "reduce the drug's effectiveness, deny its use to a large amount of patients and probably restrict the chances of long-term survival to three to five years, rather than five to 10 years".

Nice was set up in 1999 as part of the Government's bid to end " postcode prescribing", where drugs and treatments were funded in some areas of the country but not others.

A number of Nice's decisions have caused controversy: last year it blocked the multiple sclerosis drug Beta Interferon while giving the go-ahead for the anti-smoking drug Zyban.

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