The National Institute for Health and Clinical Excellence (NICE) will lose its power to make decisions on whether patients should be given treatments recommended by their doctor.
GPs will decide whether or not a particular drug is the right and most effective one for each patient. After 2014, NICE will advise doctors on which drugs are most effective.
Switching the power will not solve the problem, as the reality is the money is not available for everyone to have everything they want.
NICE will continue to appraise new treatments and advise doctors on the evidence base for their effectiveness, but it will no longer issue NHS-wide guidance on what should or should not be funded.
NICE has often misread the public mood in rejecting clinically effective drugs for rare cancers. It has placed insufficient weight on the importance of allowing the NHS to give patients with rare cancers the drugs that their doctors believe will extend or improve the quality of their lives.
But there are concerns that giving doctors the power to make decisions about new drugs could result not just in a postcode lottery of access, but by individual GP and patient too. With the cost of drugs rising and likely to continue to rise, some degree of rationing will still be required.
Some private medical insurance policies will pay for drugs that NICE has not approved.
Private medical insurance: News update: 8 November 2010