Doctors' leader hits out at 'inhumane' NHS care rules

Published on Monday 30 June 2008 22:19

DENYING patients free treatment because they choose to pay for drugs not available on the NHS is inhumane, the leader of Scotland's doctors says.

Dr Peter Terry, chairman of the British Medical Association (BMA) in Scotland, said many terminally ill patients were looking for lifelines and should not be denied the chance to buy drugs not provided by the NHS.

So-called "co-payments" are not allowed within the NHS in Scotland, meaning those who want to pay privately for a drug also have to pay for other elements of care, such as scans and blood tests.

Several high-profile cases involving co-payments have emerged in England in recent months.

But experts believe that with more expensive drugs coming on to the market, the issue will grow in Scotland as well in the coming years.

The BMA's conference in Edinburgh next month will hear calls from doctors to permit co-payments in the NHS.

Politicians and some campaigners have claimed that the payments will lead to a "two-tier NHS". But many doctors believe that co-payments are a recognition of the reality of healthcare rationing in the UK.

A BMA conference of consultants recently voted narrowly in favour of co-payments. But the organisation's main conference in July will decide national BMA policy on the issue.

Speaking ahead of the meeting, Dr Terry said while the issue was "difficult", he believed co-payments should be allowed.

"These are drugs that have been considered by the National Institute for Health and Clinical Excellence down there or the Scottish Medicines Consortium up here, and it has been decided that the money from the NHS is best spent in a different way," Dr Terry said.

"Patients, if they have a different view, should be allowed to exercise that freedom and should not be penalised as a result of doing that. That seems like a humane way of doing it."

Last week the Scottish Parliament's public petitions committee called for greater clarity from the Scottish Government on the issue.

And at Westminster Alan Johnson, the Health Secretary, has ordered a review of the co-payments policy in England.

Dr Terry said withdrawing free NHS care from patients wanting to pay for non-NHS drugs was punishing them unnecessarily.

Charities have expressed concern about the future effect of allowing co-payments.

Ian Beaumont, from Bowel Cancer UK, said: "In the short term, allowing co-payments will help more patients get access to treatment. But the trouble is what kind of effect it will have in the long-term. There are currently 63 bowel cancer drugs in development, some of which will make it to market.

"Allowing co-payments may mean Nice (the National Institute for Clinical Excellence] will not approve drugs for NHS use because patients will pay for them privately. Treatment should be based on clinical need, not ability to pay."

Ciaran Devane, chief executive at Macmillan Cancer Support, said: "We sympathise with patients who want the best possible cancer treatment and are willing to pay for private treatment in addition to NHS care.

"However, while it is an important issue for patients, it is a complex issue for the NHS because many patients cannot afford to pay for drugs privately, or risk getting into serious debt."

The Scottish Government confirmed that under current rules, any patient wanting to pay privately for a drug would also have to pay privately for other elements of their care for the same condition.

But they pointed out that patients also had the option of speaking to their health board about the availability of drugs, as arrangements were in place for exceptional circumstances.

Nicola Sturgeon, the Scottish health secretary, said: "The Scottish Parliament Petitions Committee report has set out recommendations for the provision of cancer drugs in Scotland.

"I will be considering these carefully and will respond to in due course."

Call for rethink after patients face bills for basics

CONCERN over co-payments has grown with several cases of patients in England denied free NHS care as they want to pay for other drugs privately.

The case of Linda O'Boyle has been used by campaigners to highlight calls for a rethink of the UK stance on the matter.

The 64-year-old, from Billericay, Essex, was diagnosed with bowel cancer in 2006.

She initially received NHS treatment, including chemotherapy, which lasted until September last year.

She then went on to pay 11,000 for an eight-week course of a drug called Cetuximab – which is not available on the NHS – to prolong her life. However, she was then liable to pay the bill for her basic NHS care because of the ban on co-payments.

Mrs O'Boyle died in March. Her husband and John Baron, her local MP, have campaigned for the UK government to reconsider the rules.

The policy is now being reviewed in England. Scotland is also considering its own stance as part of a response to a Scottish Parliament committee report.