Independent (KC) 14-Sep-08
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NHS to allow 'private' drugs for cancer
By Jeremy Laurance, Health Editor
Friday, 12 September 2008
Professor Mike Richards says there is 'distaste' at the idea of cancer patients being denied care on the NHS
Patients may soon be allowed to pay for "top up" drugs on top of their NHS care under a major reform to Britain's healthcare system expected next month.
Approval of top-up payments for cancer and certain other treatments is being widely anticipated from the review being conducted by Professor Mike Richards, the Government's national cancer adviser, despite fears that it could introduce a two-tier NHS.
Medical organisations have accepted that the change is inevitable in a health service that champions patient choice and is increasingly driven by consumer demand. But there is little enthusiasm for the move, which is seen as difficult to implement and would pose a long-term threat to a comprehensive NHS.
The review was ordered by Alan Johnson, the Health Secretary, in June after protests from NHS cancer patients who were told they could not pay privately for cancer drugs that had been rejected, or not yet assessed, by the National Institute for Clinical Excellence. Under existing rules, patients who buy drugs privately are excluded from receiving the rest of their care on the NHS, and must pay the full cost. For cancer patients this can amount to tens of thousands of pounds. Top-ups are already allowed in dental and optical care.
The King's Fund, the health policy think tank, became the latest NHS organisation to call for change. It said yesterday in a response to the review that the policy prohibiting top-up payments for drugs was "untenable". But safeguards should be introduced to "minimise the risks of unfairness", by restricting the circumstances in which they could be made.
The British Medical Association, the representative body for doctors, the NHS Confederation, an association of groups linked with the NHS, and the Royal College of Nursing have also reluctantly supported top-up payments.
At a meeting hosted by the King's Fund yesterday to debate the issue, attended by Professor Richards, leading figures in the health service raised concerns about top-ups without explicitly opposing them.
Professor Martin Gore, medical director at the Royal Marsden Hospital in London, said there was a "quantum difference" between paying for cancer drugs, which could be required for months or years, and paying for one-off items such as dental crowns. "The only people who are going to be able to afford [cancer drugs] are those in whom they don't work," he said.
Many social groups such as pensioners were not going to be able to afford the drugs. "Is that a deserving end for people that have given to the NHS all their lives? Is that what pensioners deserve?" he said.
Professor Richards said there was broad agreement that there was a limit to what the NHS could do, but there was "distaste" at the idea of people being denied NHS care. Views on introducing top-ups were polarised, he said. "It is not possible to find a solution that meets everyone's aspirations."
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