National is exposed on the issue of funding miracle melanoma drugs and it has only itself to blame.

It sounds hollow, hypocritical and heartless every time it says that decisions on funding must be left to the professionals at Pharmac because it argued the opposite when it was in Opposition.

It made plenty of mileage out of its election campaign promise in 2008 to extend treatment of the breast cancer drug Herceptin from nine weeks to a year.

It highlighted the higher standard of treatment in Australia and a willingness in New Zealand to accept less.

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And now the tables are turned.

Australia funds the life-saving drugs the New Zealand Government is refusing to champion.

Ordinary New Zealanders are doing extraordinary things to keep their loved ones alive.

In a perfect world, all public policy decisions would be made by dispassionate civil servants based on the soundest advice.

But politicians need to keep it real.

The Government's position that it must keep at arm's length from the decision-making process is acceptable only for as long as it is working and it is fair. It isn't on either count.

Patients with advanced melanoma have no reasonable treatment available in the state health system. But they do have in the private system.

The dying have to be wealthy, or have access to wealth, to have a chance of survival.

The law allows for directions from ministers.

The Crown Entities Act allows the responsible minister of any Crown agency to direct the entity to give effect to a Government policy that relates to the entity's functions and objectives.

The only constraints in terms of directions to Pharmac are that the minister cannot require Pharmac to make a purchase from a particular source or at a particular price, and it cannot issue directions that would provide a pharmaceutical or a subsidy to a named individual.

The best the Government can come up with is that Pharmac is involved in complex negotiations with manufacturers of the new generation of melanoma drugs and they will probably be available in a few months.

That was what they were saying three months ago.

Is it what they will be saying in another three months?

National carried out its Herceptin promise as one of the new Government's top priorities in John Key's 100-day action plan on taking office.

There is nothing stopping it doing so again. It is holding out on a matter of principle. It is just hard to know what that principle is.

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