‘The NHS risks putting principles before people’

In light of the rocketing price of newly available drugs assessed by NICE as clinically effective, many people don’t have to imagine this scenario – it is their reality.

It is known as a co-payment or top-up fee – where patients pay for private treatment on top of their normal care – but it has an ugly side. Current guidelines advise that patients cannot have both private and NHS status for the treatment of a condition during a single hospital visit. Essentially, this has allowed trusts to deny further NHS care for those who have privately funded some of their treatment, such as medication, and, as a result, people are dying.

People like 64-year-old Linda O’Boyle from Essex, who was refused NHS treatment for bowel cancer after she had privately paid for an eight-week course of a drug her trust couldn’t afford. She died earlier this year.

Announcing a review of co-payments in June, health secretary Alan Johnson appears to be dallying over their legitimacy. He has said that the government wants to be fair to patients, while safeguarding the principles of the NHS. He believes that it is a ‘complex issue’ and needs to be examined carefully.

What a load of rubbish. There’s nothing complex about allowing somebody with the financial means the right to a potential extension of their life. And denying treatment afterwards is, in my opinion, tantamount to manslaughter.

It’s not just the affluent using co-payments. Some go into debt to attain the treatment they feel they need. In these instances, a two-tier healthcare system could be said to exist. But surely those making contributions to the tax-funded system of healthcare have a right to choose without retribution?

We are rightly proud of our NHS and the principle that treatment is based on need. However, I think we defend its values too stubbornly and, as much as we like to think it can, it cannot be all things to all people.

Despite funding increases, the NHS cannot afford many of the new treatments and as such, needs are not being met. Thankfully the denial of NHS treatment following co-payment isn’t, in my experience, a common occurrence but before it becomes so, we need to argue against it before another Linda O’Boyle dies as a result.

Rob Harteveldt is a cardiac liaison nurse at Stoke Mandeville Hospital

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