ALAN JOHNSON, the health secretary, has described the review on top-up payments allowing gravely ill patients to pay for drugs denied them by the NHS as "opening up Pandora's box".

The review, conducted by the Department of Health's cancer "tsar", Professor Mike Richards, is expected to recommend top-ups be allowed after at least four deaths and a year of campaigning, led by the Sunday Times.

At present some health authorities have withdrawn NHS treatment from patients who supplement their care with private drugs.

Concerns had been expressed that allowing top-ups would create a two-tier health system.

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• Banned cancer drugs better than NHS ones

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BACKGROUND

• Ministers rethink ban on private drugs in NHS

• ‘We’ve paid into the system all our lives. Why has the NHS turned on us?’

• Doctors' anger at cruelty to patients

• Cancer patients ‘betrayed’ by NHS

• Voters call for end to ban on private drugs

Dying cancer victim was forced to pay

Linda O’Boyle was denied free treatment in her final months because she had gone private to try to prolong her life

• Cancer victim told to pay for his own drugs by NHS

• Doctors for Reform fight NHS order to halt cancer care

• Fighting cancer and the ‘unjust’ health service

Related Links

• Johnson in U-turn on patients’ top-up care

Johnson is expected to announce a policy "clarification" within the next fortnight to allow top-ups while claiming the problem had arisen because of a misinterpretation of guidelines.

"I'm glad we've done it. We've opened up Pandora's box," he said of the review, aimed at "a fair system that doesn't deny people essential treatment unduly".

The minister added he wanted to ensure "we don't undermine the basic principles of the NHS - treatment available to all, free at the point of use and irrespective of your background".

The NHS's drug advisory committee, the national institute for health and clinical excellence (Nice), is also expected to be told to give greater priority to drugs which extend a patient's life by a few months; treatments previously ruled out because they were not considered cost-effective.

The "u-turn" is expected to receive backing from Conservatives. Shadow health secretary Andrew Lansley said: “It has taken Alan Johnson months to realise that withdrawing NHS support for cancer patients who buy life-extending drugs is unacceptable. However, he still appears not to understand that there is a prior question which is, why are NHS patients in this country not getting access to new cancer drugs that are routinely available in other European countries?”

Patients who have been denied NHS care because they bought private drugs are suing for the treatment which has been withdrawn. Although dozens of NHS trusts have told cancer patients that they cannot buy private drugs while simultaneously receiving NHS care, The Sunday Times revealed in July that numerous others have been allowing top-ups.

Johnson is expected to announce a solution that will avoid creating a two-tier NHS, with patients in the same ward receiving different standards of care according to their ability to pay. One option could involve care in the home for patients who are paying for private drugs.

Nice is also expected to offer advice on effectiveness of drugs, which can cost tens of thousands of pounds, not available on the NHS.

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