Sometimes a decision taken by bureaucrats is so lacking in common sense that the only appropriate reaction seems to be to bang one’s head against a brick wall. But if a bureaucratically blinkered diktat is bad enough, when it is based on political ideology the result can be truly toxic. There are fewer more grotesque examples of such decisions than the growing number of patients, on whom we have reported over the past few months, who are being denied care by the National Health Service because they have paid out of their own pockets for drugs that the NHS has refused to provide.

According to Alan Johnson, the health secretary, it is quite right that people who pay for drugs denied to them by the NHS are then refused further NHS care. Their behaviour, he says, would lead to a two-tiered NHS. The health department says: “It is a fundamental principle of the NHS, supported by all the main political parties, that treatment should be free at the point of need. Co-payments would undermine this.”

Even if we had perfect state healthcare there would be little justification for such rules. But the NHS’s record on cancer treatment, for instance, is a disgrace. According to the latest figures, only 8% of NHS lung cancer patients are alive after five years, compared with 16% of patients in Belgium and 15% of patients in Germany. Similarly, only 17% of British stomach cancer patients are alive after five years, compared with 33% in Belgium and 31% in Germany. We lag far behind the European Union and the United States in survival rates because patients are not all supplied with the medicines they need.

Rather than those patients who have the resources to help to pay for proper treatment being punished, they should be thanked for using their own money. Jack Hose, whose case we reported last week, did not want to have to pay a small fortune for cetuximab, which in combination with another medicine provides him with the hope of survival that his NHS drugs did not.

Instead of accepting his NHS death sentence, he used his own money to find a treatment which worked. Nor did Richard Eckley want to have to spend his savings on drugs which work better for him than the cheaper medicine the health service was willing to pay for. Because these men have purchased drugs that the NHS will not pay for, they are regarded as nonpeople. The authorities would rather see them die than treat them again.

It is scarcely comprehensible that Mr Johnson, who likes to see himself as a commonsensical sort of chap, can support such a chilling policy.

It is also quite mad. Almost every parent of a child at state school who can afford to contribute to their child’s education does so, whether it is for additional coaching, music lessons, school trips or sports events. On the NHS’ logic, pupils who benefit from such financial contributions by their parents should be barred from school.

The good news is that the trusts that are denying care may be acting not just immorally but also illegally. Action is being taken to launch a judicial review of the decisions. According to Nigel Giffin QC, there is no bar in law to a patient buying drugs and having them administered as part of health service treatment. If the only reason an NHS body is not providing a course of drugs is cost, and if the patient is willing to bear that cost, then refusal to provide the treatment is irrational and unlawful.

The NHS may have signed a concordat with the private sector almost a decade ago; private providers may now contract with the NHS for some services; and private beds may now be used to shorten waiting lists. But there remains in some parts of the NHS an almost Maoist determination that the collective must always reign supreme over the individual. Hostility to private provision – to patients acting for themselves – is endemic in some parts of the service. The view that if a treatment is not provided for everyone then it should be available to no one is simply a cruel extension of that ideology.