Letter: Viagra mystery

Sir: As a result of a government directive, Viagra is not, at present, available on the NHS. The implication from Dr Richard Pearcy's letter (17 September) is that it is, however, available if you pay for it. The situation is, however, even more restrictive than this.

Several health authorities, at least, have sent out directives to GPs stating that they must not prescribe Viagra to their NHS patients even on a private prescription, or they "will be in breach of their terms of service". So even if you are willing to pay, you won't get it from your GP.

GPs are, rightly or wrongly, forbidden to issue private prescriptions for drugs available on the NHS (even when this would lead to a reduction in cost to the patient). However, it is very unusual for this ruling to apply to drugs not available on the NHS.

Even more bizarrely, this directive means that patients can be prescribed the drug by any doctor other than their own GP - the one person who in fact knows their medical history.

What is going on here?

Dr DAVID A HARRIS

Oxford