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Thousands of patients will learn today that they can pay for the latest drugs to “top up” care from the NHS.
Ministers are expected to announce that there is no legal reason why patients should forfeit their free NHS treatment if they pay for extra drugs, despite accusations that this contradicts the founding principles of a publicly funded health service.
The Times disclosed in September that restrictions on “co-payments” would be relaxed after Alan Johnson, the Health Secretary, asked for a review.
Mike Richards, the national clinical director for cancer, who conducted the review, will announce measures to widen access to the latest drugs and ensure that as few people as possible have to pay extra for treatment. There will also be guidance for health service managers on when “co-payments” are appropriate.
Professor Richards is likely to suggest that those who wish to “top up” their treatment might be treated by a different doctor or in a different hospital from the one administering their NHS care. These patients are also likely to be asked to pay the additional associated treatment costs incurred by the NHS, up to a limit.
Mr Johnson is expected to present the final report to Parliament this afternoon. Any changes to NHS guidance will be accompanied by measures to help the National Institute of Health and Clinical Excellence (NICE) to publish its recommendations about the cost-effectiveness of a drug within three months of it being licensed. At present this can take two years, after which the watchdog can refuse or limit its use. Patients whose doctors still recommend a limited treatment must persuade a local committee that they are an exceptional case, but if that fails, some may wish to pay for treatment.
NHS guidelines state that patients should not mix and match public and private treatments in the same “episode of care”, but at least 30 hospitals in England allow patients to do this.
Ministers were driven to examine the issue after a public outcry over the death in March of Linda O’Boyle, a grandmother denied free NHS treatment after buying a drug to treat her bowel cancer.
A senior Department of Health source said that the Government had acknowledged the “harsh implication of withdrawing NHS care and charging patients for costs after they paid for extra treatment”. “That is what we are trying to resolve,” he said.
Up to 15,000 patients a year appeal to primary care trusts (PCTs) to receive drugs that are not available on the NHS because they are not yet approved by NICE.
Charities say that cancer patients, in particular, are being denied the latest, high-cost drugs, which are not considered cost-effective but can allow extra months or years of life.
Scotland is conducting its own review on co-payments specifically for cancer treatments.
The British Medical Association said yesterday that the existing guidance for English hospitals had to change. “As new expensive drugs become available and the population ages, it is increasingly important that society recognises that there are very real limits to what the NHS can and cannot do,” a spokesman said.
Ministers are keen to avoid a situation where two patients on the same ward receive different standards of care because one can afford to pay for drugs and one cannot.
The Rarer Cancers Forum suggests that the average yearly cost of a top-up payment for the latest cancer treatments would be £21,000.
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If you have an operation in a private hospital, for which you have paid seperately, and it all goes horribly wrong, the chances are you will receive emergency treatment at an NHS hospital. Buying extra drugs is no different.
David Leslie, Perth, Scotland
Ah, the joys of socialized medicine. High taxes, political hacks deciding what treatments you are allowed to get. It's amazing more of you aren't dead from it. Socialism at its finest. Just remember, you guys voted for this stuff over the past 50 years. Of course it looks like we may be joining you.
Chris R, San Diego, California, USA
To deny any British person access to NHS treatment, regardless of circumstance (especially when they have paid taxes) is a breach of their human rights.
It is time that this injustice ended, and the socialist politics of envy are removed from the equation.
peterj, aberdeen, uk
People are missing the point. You can already 'top-up' for dental treatment, maternity care etc etc. The Australia Govt incentivises the public to use both the private and public systems. This relieves the public system by encouraging elective surgery into the private system.
N H, London,
The government is to allow top-up payments for new cancer drugs. Might they go one stage further and submit to NICE the existing, anecdotally ineffective NHS cancer treatments, supplanted by the new drugs, for an assessment of their cost effectiveness vis-à-vis the new ones that are free elsewhere?
Ian Clark, Hartlepool, England.
Dont take this on face value.
Now the pressure will be off approving new drugs - you will be expected to pay (unless its an Aids drug.
But what about the poor?
Ah well, means testing will come in.
That way you get to pay twice - once through taxation and once by using your life savings.
Geoff M, Bromsgove, England
Win win for the patient , the government and for the patient who can't afford to go private as there will be more money left in the N.H.S pot for them.
A good policy that benefits the nation .
When was the last time you heard that.
Running the country can be simple if you take politics out.
Nick Dixon, Sutton Coldfield, England
As a working man whose paid in to the system for 48yrs I'm entitled to NHS treatment.
I choose not to spend my money on cigarettes,gambling,or holidays abroad,so why shouldn't I be allowed to spend it on paying for top up drugs,its all about choice.
If the NHS is inadequate,it isn't my fault.
David G, Altrincham, England
Thin edge of nu labours health wedge.
"allowed" to pay for essential drugs.
Homes possessed and sold to pay for "treatment"
How long before we are "encouraged to pay for it all..
Twice..
Nu labour..
Are we all blind.?
rick, newcastle, uK
So your Consultant decides that you need drug "X" which attracts top up fees. As a result he must send you to another Specialist to start afresh. What if the first Consultant is the best or the next available Specialist is miles away? Best way to treat serously ill?
Why not simply allow "top up"?
Tom, London,
SOUNDS like good news but in the hands of corrupt politicians it COULD be used as an excuse to introduce EUthenasia for those unwilling or unable to pay - or means testing for drug bills. In the hands of a Government that has incurred debt at the rate of £9,111 a second for 11 years will THEY PAY?
Greg LANCE-WATKINS, Chepstow, Monmouthshire