The Government signalled a reversal yesterday in its policy on patients who pay to top-up NHS treatments with private care.

Alan Johnson, the Health Secretary, announced a review of the rule that patients who want to pay privately for drugs are not allowed to have them administered as part of an NHS course of treatment. He asked the national director for cancer, Mike Richards, to re-examine the issue.

Mr Johnson denied that this presaged a change in policy but it reflects a growing conviction among ministers that the Government's policy would be shredded in any court hearing.

Under the policy, dying patients able to spend £10,000 on cancer drugs have been told that if they do so, they cannot have the rest of their treatment on the NHS and must pay for the lot — perhaps three times as much. At the weekend Nigel Edwards, of the NHS Confederation, a respected commentator on the NHS, called the Government's position unsustainable. Last December Mr Johnson said that allowing top-ups “would sound the death knell for a founding principle of the NHS and lead to a two-tier health service”.

In Mr Edwards view, however, “excluding patients from the NHS system because they have chosen to top-up their treatment with privately funded drugs seriously threatens to undermine public credibility in the NHS”.

John Baron, Conservative MP for Billericay, has been pursuing the issue in the House of Commons after the death of one of his constituents.

Linda O'Boyle, 64, died this year after being refused bowel cancer treatment. She had paid £11,000 for an eight-week course of the drug Cetuximab.

Mr Baron said yesterday that the current policy was “cruel as it takes care away from patients who were dying”. He said that co-payments existed in other parts of the NHS, such as in dentistry, and he asked for assurance that the issue would not be “kicked into the long grass”.

Mr Johnson responded by saying that guidance prohibiting top-ups had existed for more than 20 years. He added: “I do think it's time that somebody with the expertise of Professor Mike Richards looked at this issue.

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