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| Version 2 | Version 3 |
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| Landmark NHS top-ups decision due | Landmark NHS top-ups decision due |
| (10 minutes later) | |
| Patients in England are due to hear whether they will be able to top up NHS care by paying for drugs privately. | Patients in England are due to hear whether they will be able to top up NHS care by paying for drugs privately. |
| People are currently excluded from the NHS if they pay for treatment not available on the health service, but practice varies from place to place. | People are currently excluded from the NHS if they pay for treatment not available on the health service, but practice varies from place to place. |
| It is widely expected that ministers will lift that ban, following a four-month review of the issue. | It is widely expected that ministers will lift that ban, following a four-month review of the issue. |
| But the landmark decision will also set out how such a complex system can work alongside a universal health service. | But the landmark decision will also set out how such a complex system can work alongside a universal health service. |
| Top-up fees, or co-payments as they are sometimes called, have dominated the headlines this year. | Top-up fees, or co-payments as they are sometimes called, have dominated the headlines this year. |
| Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge - no one wants a two speed health service and this should not become a step in that direction Nigel Edwards, of the NHS Confederation Q&A: NHS top-upsA doctor's story | Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge - no one wants a two speed health service and this should not become a step in that direction Nigel Edwards, of the NHS Confederation Q&A: NHS top-upsA doctor's story |
| The Department of Health announced the review in June, after an outcry from patients over what was considered a hard-line stance and mounting evidence of an inconsistent approach by individual NHS trusts. | The Department of Health announced the review in June, after an outcry from patients over what was considered a hard-line stance and mounting evidence of an inconsistent approach by individual NHS trusts. |
| The national clinical director for cancer, Professor Mike Richards, was asked to look at the issue and has spent the last four months talking to patients, doctors, charities and NHS managers about what should happen. | The national clinical director for cancer, Professor Mike Richards, was asked to look at the issue and has spent the last four months talking to patients, doctors, charities and NHS managers about what should happen. |
| He handed his report to ministers at the end of October and the government is now ready to formally announce its verdict. | He handed his report to ministers at the end of October and the government is now ready to formally announce its verdict. |
| While it has been widely reported that the government will lift the top-ups ban, there is still much to be resolved over how such a move would work in practice. | While it has been widely reported that the government will lift the top-ups ban, there is still much to be resolved over how such a move would work in practice. |
| FROM THE TODAY PROGRAMME More from Today programme | |
| Issues raised during the consultation include what should happen if a patient runs out of money, who picks up the bill for side-effects of treatment and what can be done for those who cannot afford to top up their care. | Issues raised during the consultation include what should happen if a patient runs out of money, who picks up the bill for side-effects of treatment and what can be done for those who cannot afford to top up their care. |
| In total, 15,000 patients appealed to their local NHS trust last year after being denied treatment - and while not all of them would necessarily end up paying a top-up, it does illustrate the scale of the problem. | In total, 15,000 patients appealed to their local NHS trust last year after being denied treatment - and while not all of them would necessarily end up paying a top-up, it does illustrate the scale of the problem. |
| Professor Richards' report is also expected to set out how the number of treatments available on the NHS can be broadened. | Professor Richards' report is also expected to set out how the number of treatments available on the NHS can be broadened. |
| In recent months there has been talk of altering the way the NHS appraises the drugs it uses, as well as encouraging pharmaceutical firms to offer more flexible pricing options, such as refunds if the drugs do not work. | In recent months there has been talk of altering the way the NHS appraises the drugs it uses, as well as encouraging pharmaceutical firms to offer more flexible pricing options, such as refunds if the drugs do not work. |
| How one patient tops up his NHS care | How one patient tops up his NHS care |
| U-turn | U-turn |
| Administrations in the rest of the UK are known to be monitoring what the Department of Health decides, with Wales and Scotland already announcing they are carrying out their own reviews. | Administrations in the rest of the UK are known to be monitoring what the Department of Health decides, with Wales and Scotland already announcing they are carrying out their own reviews. |
| Liberal Democrat health spokesman Norman Lamb said: "A government U-turn on top-up payments will be a very welcome one. | Liberal Democrat health spokesman Norman Lamb said: "A government U-turn on top-up payments will be a very welcome one. |
| "The NHS cannot provide everything without regard to cost, but that is not an excuse for the injustice and inhumanity of withdrawing all care from those that want to spend their own money on life-saving treatment." | "The NHS cannot provide everything without regard to cost, but that is not an excuse for the injustice and inhumanity of withdrawing all care from those that want to spend their own money on life-saving treatment." |
| And shadow health secretary Andrew Lansley said it was paramount that the NHS was able to fund more drugs to bring them in line with the "rest of Europe". | And shadow health secretary Andrew Lansley said it was paramount that the NHS was able to fund more drugs to bring them in line with the "rest of Europe". |
| Nigel Edwards, director of policy at the NHS Confederation, which represents managers, said a change in policy would help deal with a situation which had become "unsupportable". | Nigel Edwards, director of policy at the NHS Confederation, which represents managers, said a change in policy would help deal with a situation which had become "unsupportable". |
| But he added: "Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge - no one wants a two-speed health service." | But he added: "Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge - no one wants a two-speed health service." |
| Have you paid for care that wasn't available on the NHS? What do you think should happen? Should patients be allowed to top up NHS care by paying for drugs privately? Send us your comments using the form below: | Have you paid for care that wasn't available on the NHS? What do you think should happen? Should patients be allowed to top up NHS care by paying for drugs privately? Send us your comments using the form below: |
| In most cases a selection of your comments will be published, displaying your name and location unless you state otherwise in the box below. | In most cases a selection of your comments will be published, displaying your name and location unless you state otherwise in the box below. |