Should patients be able to top up their NHS treatment?

[Morris Onions]

Should patients be able to top up their treatment by buying new drugs that aren't yet available on the NHS?

It has become a live issue as more drugs come on to the market, and more patients use the internet to research them.

Debbie Hirst has breast cancer which has spread to her liver and bones.

Debbie lives in Cornwall and she has been fighting to get a new drug, Avastin which has produced results in clinical trials suggesting it may halt the growth of tumours.

Avastin has been licensed but it is not available on the NHS.

The National Institute for Health and Clinical Excellence has yet to decide whether it should be made available to patients with advanced breast cancer, although it has not recommended it for treating advanced bowel cancer.

Debbie says it was her consultant who suggested a solution.

"My oncologist said it would cost about £60,000. There is no way they would fund it, so we said can we fund it ourselves? The answer was yes."

Debbie started saving, she put her house on the market.

Government block

But then came guidance from the Department of Health. If Debbie paid for Avastin she would have to pay for all her treatment.

Debbie says she was furious.

"I was heartbroken because I thought it was cruel and rotten. There's a drug there, but I can't have it because it is too expensive. If I can fund it why can't they accept that money?"

The government says the rules on this are clear. You can't mix and match between private care and the NHS.

You either go all NHS and it is free, or you go all private and you pay for everything.

A Department of Health spokesman said: "If those who can afford it start "topping up" their care it will create a two tier NHS. What about those who can't afford Avastin?"

Debbie has instructed solicitors in Manchester to take her case to judicial review and she's determined to go to court.

Melissa Worth, from the law firm Halliwells, said: "There is nothing in law to say the Trust can't allow you to pay privately for the drug to top up the NHS treatment you are receiving at the moment."

What makes things worse for Debbie is there are already three patients in Cornwall who are paying privately for Avastin and being treated on the NHS.

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http://news.bbc.co.uk/1/hi/health/7219373.stm

[LeftishBrit]

1. I think that the drug should simply be available on the NHS...

Having said that, many people 'top up' NHS with private treatment in other situations; e.g. mostly using the NHS but seeing a private doctor occasionally; using an NHS doctor and a private dentist (very common); etc. - so this rule seems really unfair in this case.

I expect that the pressures will force NICE to approve the treatment in the end - but for someone who already has stage 4 cancer, that could be too late.

[Morris Onions]

2. my sentiments entirely

[cedric]

3. Only a matter of time

till the NHS gets privatised.

[Lydia Leftcoast]

4. You'd better hope that doesn't happen

You'll be in the same mess that we Americans are: increasingly unaffordable insurance premiums to companies that deny your claims and force doctors to spend hours per week on paperwork--and pay their CEOs multimillion dollar bonuses while claiming that the rises in premiums and cuts in benefits are due to anything but their own greed.

Patients hate it more and more every year. People who used to be satisfied with their insurance are finding that their premiums are going up as coverage goes down. Doctors like my brother hate it, because the companies will think up any excuse they can to deny payment. (Private doctors here have no guaranteed income except what insurance companies or patients pay them.)

Whatever flaws the NHS has, undo the Thatcherite "reforms" and fund it decently, and you'll be miles ahead of us.

P.S. Do you know what a "deductible" is? Mine is $5,000 (£2,500). That means that I'm fully responsible for the first $5,000 of medical expenses. After $5,000, the insurance company pays 80%. That's right. If I were to need $100,000 worth of medical treatment, I would be responsible for $24,000 of it, more than half my annual income. For the privilege of not owing the full $100,000, I pay the insurance company $210 a month. If I wanted a lower deductible, the monthly premium would be completely unaffordable. My sin is being over the age of 50.

That, my dear cedric, is the reality of private medical care.

Oh, and when I was in the UK last summer, I read that United Health is one of the companies itching to get its filthy fingers into your medical system.

Be afraid, be very afraid.

United Health is headquartered here in Minnesota. It is so sleazy, even by the generous standards applied to insurance companies, that the state attorney general does not allow it to sell policies here.