stethoscope.jpgAccording to a front-page story in yesterday's Sunday Times [3], "A woman will be denied free National Health Service treatment for breast cancer if she seeks to improve her chances by paying privately for an additional drug."

Preventing patients from topping up their NHS care privately is standard practice in the UK, and in accordance with Department of Health guidance. The Department seems to think that you have to be either a private patient or an NHS patient, and that any mixing is unacceptable: "Co-payments would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS."

I find it sickening that the government persists in putting their Soviet-era ideology ahead of the health of patients (which is surely the ultimate principle and value of the national health service). Rather than challenging the wholly artificial and enormously damaging public/private divide in health services, they would rather we simply received a lower quality of care. Their position is immoral and impractical.

It is also incoherent. People can already pay for private rooms in NHS hospitals, and for other non-clinical benefits. If it's ok to pay extra for your own television set, why on earth should you not be allowed to pay extra for a better drug?

Most importantly, their position may be illegal. I was recently at a luncheon addressed by one of the UK's leading medical lawyers. His position was as follows: the NHS Act entitles you to receive care that you reasonably require. You can only be refused that care if there is some legitimate reason to do so. Limited resources is such a legitimate reason. But if you are willing to pay for an additional treatment yourself, resources are not an issue and no legitimate reason to deny the reasonably required treatment exists. Thus you should be free to top-up your NHS care with privately purchased treatment, without being forced to foot the bill for the NHS services as well.

Immoral, impractical, incoherent and possibly illegal. This is just the kind of thing we've come to expect from government.