TEN years ago this newspaper campaigned successfully to bring treatment for patients with heart disease into line with the rest of Europe.

A decade later, it seems the way our new drugs are licensed is once more lagging behind other countries. This leaves patients with life-threatening illnesses in a terrible dilemma: either pay for private treatment or accept their fate.

The villain of the piece is the National Institute for Clinical Excellence. It is ironic that the NHS watchdog is more commonly known as Nice. Patients on the receiving end of its judgments could be forgiven for thinking the organisation is anything but.

The institute has been criticised by charities and patient groups, which have accused it of banning or limiting the use of some drugs because they would cost the NHS too much.

As long ago as 2002, MPs said there was "considerable confusion" on how the institute decides which treatments offered value for money. They called for greater clarity on how Nice decides which drugs should be available for patients.

Yet the decision-making process remains as mystifying as it ever was.

The Court of Appeal clearly agrees. It has ordered Nice to reveal the formula it uses to decide on cost-effectiveness.

We say this cannot come a moment too soon for the thousands of patients waiting for new drugs already available elsewhere - sometimes as close to home as Scotland.

The lack of transparency does Nice no favours. It reinforces the impression that judgements seem to be made on a whim. One treatment is given the go-ahead while another is banned.

By opening up Nice to scrutiny we can at least have a debate with all the facts before us.

And until Nice can provide a compelling reason why advanced drug treatments should not be available to all NHS patients, this paper will continue to campaign on their behalf.