MPs consider top-up healthcare plan

23 September 2008

MPs are reported to be planning to allow patients to mix and match NHS care with private treatment, a move which opponents fear could spell an end to the NHS and disadvantage poorer households.

Under existing rules, patients cannot top-up NHS care with private care because it breaks with the fundamental principle of the NHS - that it is free at the point of need.

However, back in June the health secretary Alan Johnson asked the government’s national cancer director, Mike Richards, to conduct an independent review of the current system with a view to potentially changing the rules.

Richards is due to report back at the end of October. Athough no decisions have yet been made, speculation is mounting that he will conclude the current system is unsustainable, with many doctors and nurses frequently turning a blind eye to patients who choose to supplement their NHS care privately.

“Top-up healthcare is a difficult issue," says a spokesman for the NHS Confederation. "On the one hand, it’s easy to argue that it goes against the founding principles of the NHS, that it should be free at the point of need, but on the other it is difficult to deny patients the right to life-extending drugs.

“However, it goes without saying that the NHS can’t just print a blank cheque and keep paying for everything.”

Opponents to top-up healthcare warn that allowing patients to top-up their healthcare will not only undermine the NHS, it would also result a two-tiered system with wealthier patients living longer and being able to afford expensive drugs that are not available to poorer patients.

Ian Beaumont, a spokesperson for Bowel Cancer UK, says: “We see top-up healthcare as leading to a slippery slope of worse things to come, such as a two-tier system of healthcare, which would negatively affect those people who can’t afford to pay.”

Beaumont admits that a top-up system of healthcare could benefit some patients in the short-term, but he warns that might also discourage the National Institute of Health and Clinical Excellence (NICE) approving drugs for NHS patients.

He adds: “People should be able to pay for healthcare if they want to, just as long as it does not prejudice those who are unable to pay.”

However, those who favour top-up healthcare argue that a postcode lottery already exists where patients in some areas are granted treatments that could extend their lives while others are not.

“Patients would just buy drugs secretly on the underground market if the NHS did not allow top-ups,” claims Professor Karol Sikora, director of Cancer Partners UK.

Earlier this month, the King’s Fund, a health policy think tank gave its backing to top-up healthcare, arguing that the NHS risked being seen as uncaring if it did not approve rule changes.


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