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NHS top-ups could split doctors Doctors call for top-ups review
(about 6 hours later)
Doctors at the British Medical Association conference are to discuss the issue of NHS patients paying to top up their care privately. Doctors have called for a thorough and independent review of the ban on NHS patients paying to top up their care.
Anyone in the UK who pays for any form of private treatment can be barred from the normal package of NHS care.Anyone in the UK who pays for any form of private treatment can be barred from the normal package of NHS care.
Ministers in England and Scotland have announced reviews of the guidelines. In a debate which split the British Medical Association annual conference, doctors voted for a motion calling for so-called co-payments to be allowed.
BMA chairman Hamish Meldrum has indicated he is uneasy about co-payments, but consultants have previously voted in favour. They called for a Royal Commission review - but stopped short of demanding an immediate end to the current ban.
Doctors will debate the issue at the BMA's annual conference in Edinburgh on Wednesday. And Dr Stephen Austin, of the BMA's consultants committee, said: "This is grossly unfair to these patients at the most vulnerable time of their life. Dr Stephen AustinBMA consultants committee class="" href="/1/hi/health/7495971.stm">'Why can't we buy drugs?'
This is one of the most important issues the NHS faces, but it is so complex Jonathan FieldenBMA's consultants committee Q&A: NHS co-payments'Why can't we pay for extra drugs?'
The issue has come to a head in recent months as a number of cancer patients have been banned from receiving NHS care after topping up their treatment privately.The issue has come to a head in recent months as a number of cancer patients have been banned from receiving NHS care after topping up their treatment privately.
It has resulted in some terminally-ill patients being forced to decide whether to pay for health care that would normally be free, or go without drugs that could help extend their lives.It has resulted in some terminally-ill patients being forced to decide whether to pay for health care that would normally be free, or go without drugs that could help extend their lives.
Final decision Ministers in England and Scotland have already announced a review of the guidelines following a public outcry, but this is just limited to drugs.
On the eve of this week's doctors' conference, Dr Meldrum said his "gut instinct" was that it went against the values of the NHS. Doctors want it to be carried out independently and also look at a range of other areas of care.
But he also said there needed to be a thorough debate and other options considered such as speeding up the way drugs are recommended for use in the NHS before a final decision was made.
This came after the consultants group within the BMA had said co-payments should be allowed in a meeting earlier this year.
Jonathan Fielden, chairman of the BMA's consultants committee, said: "This is one of the most important issues the NHS faces, but it is so complex.
"There is a wide variety of opinion among doctors and I think society as a whole has to consider this properly as we are going to see more and more cases as medicine advances."
He refused to disclose his personal view on the issue, but said the reviews taking place were not adequate.
In England's case it focuses on drugs in general, while in Scotland it is just on cancer drugs.
Mr Fielden said he wanted to see an independent commission set up to look at the issue and cover all forms of NHS services and not just drugs.
Surgeon Gordon Matthews, who is due to speak at the conference, believes co-payments should be allowed.
His wife Sue has advanced bowel cancer and he said there could come a point where they would have to consider paying for a drug not available on the NHS.
"I accept there has to be a threshold and that the NHS cannot afford to pay for everything. But why should we be penalised if we want to pay for drugs not available?" he said.
While access to drugs have hogged the headlines in recent months, patients are known to have paid for diagnostic scans to jump waiting lists, while mixing private physio treatment with GP appointments is relatively common practice.While access to drugs have hogged the headlines in recent months, patients are known to have paid for diagnostic scans to jump waiting lists, while mixing private physio treatment with GP appointments is relatively common practice.
On the eve of this week's doctors' conference, BMA chairman Dr Hamish Meldrum said his "gut instinct" was that it went against the values of the NHS.
But he also said there needed to be a thorough debate and other options considered such as speeding up the way drugs are recommended for use in the NHS before a final decision was made.
Passionate debate
In a heated debate, the conference heard from Gordon Matthews, an orthopaedic surgeon whose wife is dying from bowel cancer.
He said the current rules are unfair on patients who are "clinging to their own lives".
It would overturn a basic principle of the NHS Jacky DavisConsultant radiologist
"This is not a threat to the NHS. A tax-based system cannot provide unlimited treatment."
He was supported by consultant David Wrede, a member of the centre-right Doctors for Reform group.
He said those against co-payments had an "emotional attachment to some kind of fantasy of what the NHS should be."
And Dr Stephen Austin, of the BMA's consultants committee, said: "This is grossly unfair to these patients at the most vulnerable time of their life.
"This is not what the NHS stands for and goes against the founding principles of the NHS."
But a number of doctors spoke against allowing such top-ups.
Grim warning
Jacky Davis, a consultant radiologist from London, said co-payments would mean the "end of the health service".
"It would overturn a basic principle of the NHS."
Kevin O'Kane, a doctor from London, added it would be a "nail in the NHS coffin" and lead to ever tighter rationing of what is available on the health service.
"We want treatment to be available on the basis of need not ability to pay."
And Mark Porter, also of the BMA's consultants committee, added allowing co-payments would "lever open the NHS" to more charges and drug firms putting pressure on patients.
The conference ended the debate by voting on several motions.
Some 63% said they believed patients should be able to buy private treatment without losing their right to NHS care although 53% accepted that it could create a two-tier NHS.
But they narrowly voted against a motion calling for the government to permit it by 50.2% to 49.8%.
Instead, 71% voted in favour of a Royal Commission to review the issue by summer 2009.