WE all know the National Health Service is under huge financial pressure.

Those running it on a daily basis have to keep within restrictive, government-imposed cash targets.

And if those targets are not met, heads are likely to roll.

Budgetary controls are necessary because spending on the health service could otherwise be almost limitless.

But they have to be implemented in a just manner so that patients get equal treatment regardless of where they live, their own knowledge and their ability to kick up a fuss.

And families should not have to go to court to fight for the right to be treated with drugs like herceptin which has been proved to help women with advanced breast cancer.

Such drugs should be automatically provided to patients on the basis of their clinical need and not because of cost.

For that to happen there needs to a change in attitude all the way up the line.

We have seen Patricia Hewitt intervene in the case of 41-year-old Elaine Barber whose court battle to get herceptin had failed.

But despite the fact that health chiefs have said recent victories will force the NHS to pay for the drug, the Health Minister insists decisions still lie with local Primary Care Trust.

This is no good. Direction must come from the top to ensure equal treatment.