Stuart Blake: Top-ups could cure cancer treatment woes

Published on Thursday 12 March 2009 08:47

THE Scottish Government recently proposed introducing top-up payments to allow patients to supplement their NHS treatment with additional treatments paid for privately. These proposals cover a variety of situations, but much of the debate has focused on treatments for cancer.

There are treatments for certain types of cancer which are not approved for NHS use, even though there is evidence that these treatments can be effective. In many cases, they are not approved, as alternative treatments are available which are as effective clinically but more cost effective.

It's not uncommon, however, for cancer treatments available on the NHS to be unsuccessful, and in these circumstances it is only natural that people will wish to consider other potentially effective treatments, even if these are not approved for NHS use. It has been suggested that such treatments may become available to NHS patients prepared to pay top-up payments.

Many agree that there are circumstances when it would be appropriate to try these non-approved treatments, and that there must be room for compassion and that people should not be prevented from having the opportunity to consider treatments which might be effective. However, if we accept that consideration be given to these treatments, we must also consider how to make them available in the most equitable way.

One disadvantage of top-up payments is that many people would be unable to pay for expensive treatments, and we must consider whether it is truly compassionate they are available only to those able to pay.

At the Scottish Local Medical Committees annual conference this week, it will be proposed that access to appropriate cancer treatments should not be determined by ability to pay and that all appropriate cancer treatments should be provided by the NHS. The conference will provide Scotland's GPs with the opportunity to debate this issue and express their views clearly to the Scottish Government.

Dr Stuart Blake is a GP in Edinburgh