NHS patients allowed to 'top-up' care
Wednesday November 5th, 2008
An NHS ban on patients paying for "top-up" drugs was lifted yesterday, allowing patients to combine NHS treatment with private health care.
Patients in England can supplement their NHS care by paying for drugs privately, announced the health secretary Alan Johnson following a four-month review.
Until now top-up fees, or co-payments, have been banned - and patients who made them were denied free NHS treatment. A department of health review was announced in June, after patient protests and complaints over an inconsistent approach by different NHS trusts.
The national clinical director for cancer, Professor Mike Richards, investigated the issue and concluded that the ban should be lifted.
The British Medical Association has welcomed the move, saying that the announcement offers "a practical way of balancing the rights of individual patients with the values of fairness and equality on which the NHS is based".
Dr Hamish Meldrum of the BMA said: "It was morally wrong that people who self-funded part of their treatment were denied their right to free NHS care and I have great sympathy for the patients and their families who find themselves facing these terrible dilemmas."
However, he added that the BMA still wants a wider public debate about the scope of a publicly funded healthcare system, to avoid the creation of a two-tier system.
Nigel Edwards of the NHS Confederation echoes this concern. He warned: "Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge. No-one wants a two speed health service and this should not become a step in that direction."
Health bosses in Wales and Scotland have announced that they are carrying out their own reviews.
Announcing the rule changes, health secretary Alan Johnson said further measures would be taken to speed up appraisal of expensive drugs for severe illnesses.
The National Institute for Health and Clinical Excellence - NICE - has agreed to introduce "greater flexibility" in its handling of these drugs.
NICE has continued to be criticised for failing to reach verdicts on new drugs fast enough - leading to patients deciding to pay for their own treatment.
Mr Johnson said: "A small number of patients may still choose to pay for additional drugs not available on the NHS. But I have agreed that, from today, NHS care must never be withdrawn in these cases - as long as private treatment takes place in a private facility.
"This issue was causing distress to patients and their relatives - and none of us wanted that uncertainty and inconsistency to continue. Patients and the public can be confident that from today there will be greater clarity, greater fairness and, most importantly, greater access to a wider range of drugs."
NICE yesterday issued a consultation on its proposals, which would allow costs to be disregarded for rare diseases - on the grounds that treatments for small numbers of patients may be especially expensive to develop.
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