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Top-up fee rule change could disrupt care, warn MPs

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The end of the ban on patients paying for extra drugs to top up NHS care could compromise care, according to the Commons health select committee.

The government lifted the ban in England in November, but insisted extra treatment must be administered separately from NHS care.

The Commons Health Committee report said it was the only realistic way forward, but warned such a separation would be difficult to achieve in practice. They also warned it could disrupt seriously ill patients’ care.

It stressed that the lifting of the ban must not be allowed to result in a two-tier system, where two patients with the same condition on the same ward received different treatments.

But they said moving a patient from an NHS ward to a different location for private treatment could potentially compromise their care.

The MPs also criticised new rules from the National Institute for Health and Clinical Excellence making it more likely that drugs which can extend life for people with rare diseases will get NHS approval.

They said the new rules meant that more would be spent on treatments which offered a limited benefit, at the expense of treatments which gave greater benefits to more patients.

The committee calls for the Department of Health to monitor the new rules closely, and fund research to assess their effectiveness.

Kevin Barron MP, chairman of the Health Committee, said the issue was highly complex. He said the option of separating NHS and private care was the only one likely to address most effectively the confusion surrounding the debate.

Mr Barron said: ‘Other options, such as a voucher scheme, appear to be unworkable or would undermine the fundamental values of the NHS. Nevertheless, there are real concerns which will need to be carefully monitored.’

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