Doctors vow to meet Viagra demand

WHAT HAS most angered doctors about Frank Dobson's decision to restrict prescribing of Viagra is the suggestion that impotence is not a serious problem and that men who want sex should pay for the treatment.

Today's doctors spend much of their time doling out drugs to patients with chronic conditions, to little effect. There is near-universal agreement in the medical community that Viagra is different because it is effective.

John Chisholm, chairman of the British Medical Association's GPs committee, said: "This is a condition that creates very real problems for thousands of men, affecting their relationships and causing psychological distress. The idea that it is some kind of joke condition that can be excluded from the NHS is one that most doctors find offensive."

Issuing guidelines that have been delayed for four months, Mr Dobson said he was acting on advice from the Standing Medical Advisory Committee, which noted the average frequency of intercourse in the 40-60 age group, the prime market for impotence treatments, was once a week.

Only men with diabetes, multiple sclerosis, single-gene neurological disorders, spinal and prostate problems or who have had radical pelvic surgery will be able to get treatment from their GP on the NHS. In exceptional circumstances men caused "severe stress" may also qualify but only after referral to a hospital consultant.

Justifying the limits on NHS prescribing, the Health Secretary said the unpleasant nature of older treatments, such as injections, had deterred all but the most determined patients and limited spending. Now it was available in tablet form, demand could escalate.

"The cost could increase tenfold or even more ... Impotence in itself is neither life-threatening nor does it cause physical pain ... We have to find a sensible balance between treating men with a distressing condition and protecting the resources of the NHS to deal with other patients, for example with cancer, heart disease and mental health problems."

The BMA reacted with fury and pledged to campaign to have the guidelines changed. Dr Chisholm said: "Doctors believe it is totally unethical to discriminate among patients with equal clinical needs on the crude basis of the causes of their condition. Viagra is a drug that is legally prescribable. We believe GPs should be meeting their patients' clinical needs at the moment."

David Delvin, who runs private clinics for people with psycho-sexual problems in London and Cambridge and has treated more than 100 patients with Viagra, said: "This drug is not being misused by silly people who want 16 orgasms a day. It is being used by people who are trying to pull their relationships together."

The typical patient was a man aged 45 to 70 who was "thunderstruck" that he could no longer have intercourse with his wife. "The blow to their confidence is colossal."

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