GPs question the need for patient co-payments

The boundaries between NHS and private treatment could blur after the DoH reviews rules governing co-payments, health experts warn.

National clinical director for cancer Professor Mike Richards is to review a 20-year-old edict that means patients cannot receive NHS treatment with drugs they bought privately.

The rules mostly affect late-stage cancer patients willing to pay for drugs not recommended by NICE because of cost.

Professor Chris Ham, a former DoH adviser and professor of health policy at the University of Birmingham, said the government could not hold its current line on patients wanting to 'top-up' treatment.

Speaking at the BMJ's summer lecture last week, Professor Ham said: 'I think this is the straw in the wind and signifies a bigger change in the NHS.'

GPC member Dr John Canning said: 'Not at the moment, but in the future, the boundaries between NHS treatment and private could get even more blurred.'

Dr Canning said it could result in a similar system to dentistry, where patients are offered many treatments at a price.

But GPC deputy chairman Dr Richard Vautrey said that it would be too politically dangerous for the government to push through such changes.

'I don't think there is any political will for this to happen. Health secretary Alan Johnson opposed this before agreeing to review the situation,' he said.

Dr Vautrey said that even in primary care, drugs would be unaffordable for most people and co-payments would be used by a 'small cohort of people who could afford it'.

Most health bodies have cautiously welcomed the review.

But BMA chairman Dr Hamish Meldrum, also speaking at the summer lecture, agreed on the need for debate but argued that an increasing element of private funding would increase health inequalities.

tom.ireland@haymarket.com

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