The man from SMAC

When health secretary Frank Dobson announced new guidelines last week for prescribing the drug sildenafil (Viagra), he was attacked by the drug's manufacturer, Pfizer, who claimed that he had gone against the advice of his own advisory team, the Standing Medical Advisory Committee (SMAC). If that were true, one would assume that the committee's chairman would have disliked the guidance. But did he?

“The job of SMAC is to give medical guidance and medical facts to ministers on which they can made decisions. The ultimate decision is a political one in the widest sense,” said Alan Johnson, chairman of SMAC and professor of surgery at Sheffield University.

“Mr Dobson has had a difficult decision to make and has had the courage to open that decision to public consultation,” he continued.

“The easy option would have been to ban it altogether on the NHS and make it available only on private prescription, as is the case in most other European countries. That would have seemed fair in that no one would have been entitled to it on the NHS.

“Another possibility would have been to limit all NHS prescriptions to hospitals, but then urologists would have been overwhelmed. A third option would have been to …