A top NHS manager was yesterday publicly asked by the wife and daughter of a dying cancer patient why he could not get a life-prolonging drug.

At a meeting of Oxfordshire PCT's Patient and Public Involvement Forum, Ljuba Stirzaker, Oxfordshire Primary Care Trust's consultant in healthcare priorities, refused to talk about Martyn Sumner, whose request for a life-prolonging drug was denied last week.

Mr Sumner, who was given 10 months to live after being diagnosed with cancer in October, is now seriously ill in Sobell House.

The only treatment available to him is Sunitinib - a £2,500 a month drug which he cannot have on the NHS.

He is now planning to launch a judicial review in the High Court, asking a judge to look at clinical evidence and overturn the PCT's refusal for his treatment.

Yesterday his family, of Bertie Road, Cumnor Hill, joined about 40 people at the forum to listen to Mrs Stirzaker's talk about difficult decisions in healthcare - which was dubbed "rather sobering" by the forum chairman Mary Judge.

Mr Sumner's wife, Janet, 49, and daughter, Laura, 22, fired questions at Mrs Stirzaker, querying why the PCT repeatedly turned down expert cancer consultants' requests for Sunitinib, and why they could deny a £2,500 drug when they had saved £1.5m in their prescription budget.

Their attack ended when Mrs Sumner said: "My husband is dying and you need to sort this out yesterday."

Miss Sumner said: "You talk about patients going deaf, patients going blind and people dying of cancer, but on the other hand you have £1.5m in the bank - is it doing the most good there?"

Mrs Stirzaker said: "You are talking about the savings made from our prescription budget and that money is not in the bank, it will be going somewhere else.

"Every year we're asked to make savings in order to invest money somewhere else. It doesn't mean we're just sitting on it."

During her talk, Mrs Stirzaker said the PCT had a £750m budget, which gave managers about £1,200 to spend on every Oxfordshire resident - considerably less than other areas of the UK.

As a result, she said, staff had to make difficult decisions to prioritise drugs and treatments, based on clinical effectiveness.

She said: "The fact is that whatever system we have there's never enough money for everything. The big thing is about new technologies and new drugs that are coming on-stream all the time and they're very expensive.

"We have to do the best we can with the money we have. Every pound we spend on one patient is a pound we can't spend on another.

"It's sometimes very difficult and hard for us, but in the end the decision has to be made on clinical need and outcome."

Mrs Stirzaker would not answer questions relating to Mr Sumner's case.

She replied: "When a consultant has a patient in front of them that's their biggest priority. I treat populations and I have to consider the whole population. We're only too well aware that population decisions can clash with individual needs.

"I do not think it's appropriate to talk about individual cases, but there'll be an opportunity to talk about this after the meeting."

The Sumners left claiming there was "little point" talking to Mrs Stirzaker in private.

District nurse Mrs Sumner added: "She already seems to have all the answers."

Kidney cancer patient Stephen Dallison, who won his battle to be given Sunitinib, has now started the treatment.

So far the 33-year-old from Iffley Road, Oxford, has experienced no problems since he began taking the drug last Wednesday.

He said: "I started using the drug last week and have been fine. The last treatment I was on, Interleukin-2, was quite stressful and I lost a lot of weight.

"At the moment I feel okay. But the course I have to take is 28 days on and then 14 days without having to take the pills, so I imagine any effects, if there are any, will kick in then."

Mr Sumner is receiving hospice care at Sobell House in the Churchill Hospital, Headington.

His wife said: "Martyn is currently receiving radiotherapy treatment for the pain he is experiencing.

"He came back from Sobell House for lunch over the weekend and hopefully he will be home for a bit longer this weekend, but nothing is certain yet."