It is good to see old fashioned centralisation is alive and well in sensitive matters.

What began as an interim £50m fund for cancer drugs in July was confirmed last month as a £200m per year pot, available for three years from next April. The Department of Health has begun a consultation process on how the new fund should operate.

We can now look forward to a time where it is the kindly GP rather the “faceless bureaucrat” who denies us our lifesaving remedy

Access to new cancer treatments, especially those turned down by the National Institute for Health and Clinical Excellence or awaiting its approval, emerged again as a doorstep issue during the general election campaign. The term “postcode lottery” was invoked. Andrew Lansley’s announcement of the new fund “in addition to what primary care trusts already spend”, promised to “help patients in England get cancer drugs that are readily available in the rest of Europe”, and trumpeted the virtues of “putting the clinical experts in charge of making decisions”.

Successive governments have learned there are excellent political reasons for having an NHS intermediate tier.

Mr Lansley’s “clinically led panels” in each region, charged with deciding how the £200m is spent, may be a pragmatic approach, despite the unfortunate echoes of “death panel” rhetoric.

It is simplistic to imagine the evil, grasping hand of big pharma pulling the health secretary’s strings. Why shouldn’t industry expect a speedy and objective approval process?

The perniciousness of the cancer drug fund, along with recent media critiques of NICE, is the implicit retreat from rationality. Cancer is elevated to a special status. Above all we must preserve the hope of a breakthrough, a magic bullet to eradicate it.

Oh wicked NICE, daring to impose even a crude cost-benefit analysis on our hopes and dreams.

And, of course, the wicked must be punished - hence health minister Earl Howe announcing NICE’s “somewhat redundant” future as GP consortia take up the burden of deciding which drugs the NHS should buy.

We can now look forward to a time where it is the kindly GP rather the “faceless bureaucrat” who denies us our lifesaving remedy. No government could dream of a better “intermediate tier”.

Noel Plumridge is an independent consultant and former NHS finance director, noelplumridge@aol.com.