Ministers in U-turn over the right to 'top-up' NHS treatments

(Independent Graphics)

Ministers have bowed to public and political pressure and performed a U-turn over rules denying NHS patients the right to top up their care with treatment paid for privately.

Alan Johnson, the Health Secretary, announced a review yesterday of the current policy which requires patients who choose to buy drugs not available on the NHS to pay the whole cost of their care.

The Government had come under pressure from cancer patients demanding the right to buy new drugs not yet approved by the National Institute for Health and Clinical Excellence (Nice) without losing their right to free NHS care.

Linda O'Boyle, 64, from Billericay in Essex, died this year after being refused bowel cancer treatment on the NHS because she had paid £11,000 for an eight-week course of the drug Cetuximab.

John Baron, the Tory MP for Billericay, pursued the matter in the Commons, forcing ministers to defend an unsustainable position. Mr Baron said the policy banning top-up or co-payments was "cruel because it takes away care from patients who are dying" and pointed out that they existed in other parts of the NHS such as dentistry.

Last week, the Department of Health was insisting that co-payments would not be permitted because they risked creating a two-tier health service. A spokesman said the Government was committed to a publicly funded service and allowing top-up payments would be in "direct contravention with the principles and values of the NHS".

The change of heart came despite denials by the Department of Health and Downing Street earlier this week that a policy review was imminent.

Mr Johnson told MPs in the Commons yesterday that he had asked Professor Mike Richards, the national cancer director, to look into the "very complex" issues raised by top-up payments and report by October. "I'm not saying that he comes down one way or the other," Mr Johnson said. "I'm saying he needs to review this issue given the need... to protect the principles of the NHS being free at the point of need, and the concerns of Mrs O'Boyle and many other people involved to ensure we get guidance that is up to date and related to what is happening now in the NHS that is fair to everyone."

An end to the policy banning co-payments was demanded by doctors at the BMA's annual consultants conference this month. And the NHS Confederation, representing managers, said the rule was "unsustainable".

Nigel Edwards, policy director at the confederation, said the impasse on top-ups threatened to undermine public confidence in the NHS. "This is a complex issue with each side of the argument largely incompatible," he said. "We need to find a solution that recognises an individual's wish to spend money as they see fit while safeguarding the principles of the NHS.

"Many of the drugs people want to top-up on are very expensive, and may only have limited effectiveness. If we are to allow top-ups, we need to ensure that patients and the public get the best information to make the right decision for them and are not given 'false hope' at such a vulnerable time."

Ian Beaumont of Bowel Cancer UK said a change of policy would be a backward step: "Co-payments will force more people to go privately and give the Government, Nice and primary care trusts an excuse to deny patients access to effective treatments on the NHS."