An auction of French government ten-year bonds three days before the triumph of François Hollande met strong demand from investors and produced a borrowing cost of 2.96 per cent, a fraction cheaper than a similar issue in April. This fact told those who noticed it that France was not the story to watch last weekend. Markets had already assessed Hollande as a closet moderate who would rapidly be forced to back-pedal on his socialist rhetoric and embrace Angela Merkel. Flag-waving Bastille crowds made good television, but it was the Greek election and the rumblings from Spain — where Bankia, a conglomerate of savings banks, is heading for a multibillion bailout — that really mattered.
It’s hard to know which is a worse outcome for Greece: a fractious hard-left coalition or another election next month with another chaotic ‘anti-austerity’ outcome. ‘Growth’ will be the new mantra for European leaders, as a concession to Hollande, but before they can turn it into an ‘agenda’ they must deal first with urgent Greek demands for an unwinding of the bailout terms. If they concede, the problems of Spain and other depressed, debt-laden euro economies will become far harder to contain. If they refuse, Greece descends into civic collapse and violent exit from the euro.
Hollande has been welcomed onto the world stage as ‘Monsieur Normal’, an aimiable change from his rebarbative predecessor. But normality applies to Europe at large only in the context of that old wartime acronym ‘Snafu’, which I won’t spell out. The continent’s new statesman must already be wondering what he’s taken on.
Eye trouble
The row over the use of alternative drugs, Avastin and Lucentis, to treat age-related macular degeneration — AMD, the condition that is the commonest cause of sight loss in older people — offers a fascinating glimpse of the tension between the interests of patients, taxpayers and ‘big pharma’.
Both drugs were developed by the same Californian biotech company, Genentech. Lucentis is recommended for AMD treatment by the NHS watchdog Nice, but costs £700 per dose; it is marketed by the Swiss pharmaceutical giant Novartis, which sold £350 million worth of it in the first quarter of this year. Avastin was originally launched as a treatment for bowel cancer, costs £60 per dose, and is marketed by Novartis’s rival Hoffmann-La Roche, which bought Genentech in 2009 for $47 billion. Both parent companies are based in Basel, where chamber of commerce lunches must be tense affairs.
Although approval has never been sought for Avastin as an eye treatment, it is widely used against AMD by doctors on both sides of the Atlantic who believe it is as good as Lucentis — including, I should say, the top Harley Street man who treats my own mother for the condition. As an Avastin recipient, she’s in company with more than half of America’s quarter-million AMD patients. As British patient numbers head towards 20,000 — a by-product of increasing longevity — Avastin offers a potential saving to the NHS of more than £80 million a year. Some NHS areas already allow Avastin to be prescribed, but Novartis claims its side effects have not been fully explored and is seeking a judicial review on the grounds that ‘widespread use of an unlicensed treatment when a licensed medicine is available’ puts patient safety at risk.
Experts point out that elderly AMD patients are likely to have multiple ailments which make monitoring of side effects difficult. A recent US study found ‘the number of deaths, heart attacks and strokes were low and similar for both drugs’ and that although ‘serious adverse events… occurred at a 24 per cent rate for patients receiving Avastin and a 19 per cent rate for patients receiving Lucentis… these events were distributed across many different conditions, most of which were not associated with Avastin in cancer clinical trials where the drug was administered at 500 times the dose used for AMD’. In short, the case for Avastin looks persuasive to the layman and the cost accountant — but it would be foolish to take sides. Novartis shareholders expect their company to defend its commercial interests; taxpayers expect NHS managers to make savings where they can; but when money talks, medical science needs to talk louder and clearer.
Ninety-nine neighbours
I’m impressed to find 99 of my Yorkshire neighbours, everyone from Selina Scott to the local butcher, writing to the Daily Telegraph to urge communities secretary Eric Pickles to call in for review a decision by Ryedale District Council to give planning permission for a superstore on a council-owned car park in the market town of Malton, while rejecting an alternative scheme which commanded wider support in the community. Once represented in parliament by Edmund Burke — he of the ‘little platoons’ of active citizens — Malton declined from its prosperous heyday after a bypass took away much of its passing trade. But it has revived lately as a foodie destination through the efforts of small shopkeepers, market stallholders and a sympathetic estate landlord. It already has a Morrisons and a Netto, and its more vociferous residents are dead against the giant Tesco (or its like) they will get if the council now sells the car park, reaping £5 million as it does so.
With the ever-fragrant Selina to the fore, the objectors have run a superb media campaign while councillors have huddled in their nearby bunker quoting procedural niceties at one another. Localism is all very well, but even Burke might have agreed that this looks like a tinpot local authority overriding local feeling and losing the moral argument. Intervention from above is the only way to resolve such a poisonous issue: the platoon of 99, with a couple of thousand behind them, deserve a hearing from Mr Pickles. And if you’d like to assess the case for yourself, Malton is offering a Food Lovers Festival next weekend.
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