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NHS Co-payments (Mrs. O'Boyle)

I accept the hon. Gentleman's reassurances. We have some very important and serious issues to address as part of this debate. It is difficult to explain, but it would not be appropriate to talk about an individual case, so I must keep my remarks general at this stage. However, we must be clear that no one should ever be denied the offer of NHS care. That is a fundamental principle, on which our guidance is clear. Patients are entitled to switch from privately funded to NHS-funded status, and should then receive treatment on the same basis as any other NHS patient, and be offered treatment based on clinical need. Any previous status as a privately funded patient should, as far as is practical, neither disadvantage them nor allow them to access NHS care in a preferential way. More treatments than ever are now available on the NHS, and cancer treatment and survival rates in this country have improved dramatically. However, any publicly funded health care system will always have to make difficult decisions about what treatments are available, and some treatments are not generally available on the NHS. We set up NICE, which is now regarded as a world leader, to assess the clinical and cost effectiveness of drugs and treatments based on the latest evidence. Primary care trusts have a statutory duty to fund the use of drugs that are recommended by NICE technology appraisals, ensuring that proven treatments are available to everybody. The inevitable consequence of the NICE process, however, is that some PCTS will decide not to fund some treatments. For example, a treatment might not have received a safety licence from the Medicines and Healthcare products Regulatory Agency, or NICE might find that it does not give patients enough clinical benefit to justify the expense. Those decisions are never taken lightly, and NICE will always find itself in difficulty when making decisions seen to deny people drugs that they genuinely believe will make a difference to the length or quality of their lives. There is never a controversy when NICE approves drugs, but it will inevitably follow some of the incredibly difficult decisions that it must make. There has been tremendous political consensus about the virtues of having a NICE-type system to make some of those very difficult decisions: it is removed from party-politics and creates an entirely independent process governed by legislation established in this House. It is important to be clear that it would be inappropriate for Ministers to intervene in and undermine every difficult decision that NICE makes.