TIMES have never been tougher for the NHS. Funding shortfalls, coupled with an ageing population, mean resources are stretched more and more. And, with ever increasing treatments, the service is almost a victim of its success.

Some of the new treatments are expensive and hard decisions are often the rule these days, rather than the exception. Particularly difficult choices are made in the provision of care for cancer patients, as Richard Bassett knows only too well.

Richard is suffering from the rare ‘Wildtype’ Gastrointestinal Stromal Tumour (GIST) for which there is no cure. But it can be contained with Regorafenib if unresponsive to two other drugs, imatinib and sunitinib.

Earlier this year, the Cancer Drugs Fund decided to stop funding the treatment. Patients whose GIST cancer was inoperable had no other treatment available and would die sooner than might have been the case.

Now that sunitinib is proving ineffective in Richard’s case, his girlfriend, Victoria James, has collected a 45,000-signature petition calling for the drug to be reinstated.

It does seem harsh to deny people a drug that at £3,400 per month is not expensive in comparison with many other cancer drugs, yet the cancer fund points out that not reviewing such drugs would have meant cuts elsewhere.

There is also a bigger question: what should our priorities be in a health service that is already heavily in the red?

Hard choices will not go away.