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NHS Co-payments (Mrs. O'Boyle)

We will have to consider that point as a consequence of this debate. No one is suggesting that we can ignore the sensitive and difficult considerations that the issue of top-ups raises, such as whether NHS guidance is being applied consistently across the country. We have a constant debate in the NHS about the balance between having a universal, national service and having local flexibility, discretion and autonomy. To some extent, the aspiration of all Governments is to minimise postcode lotteries where possible. We know that decisions taken at the local level can, from time to time, be very different depending on the judgments of managers and clinicians, and this matter is no different to that. However, we are willing to consider the implications of the debate in the context of an ever-moving landscape of treatments and drugs that are becoming available. I conclude by quoting Dr. Colin Trask, the director of clinical oncology at Southend hospital, whose comments are important. He has said:"““At Southend hospital, our annual budget for drugs has gone from £1 million to £6million over the past decade. We have the money to spend on drugs. It's not about cost. It's about what is best, not just for a patient's life but for their quality of life…If it was in their interests, they would get””" the drug. He went on:"““Even if it is not available on the NHS, we would try to find a way to get it for them, by referring them somewhere they could get it, perhaps as part of a drug trial. But if it wouldn't help them, we would explain the drug is very toxic and would mean them spending their last bit of time in hospital feeling very ill…Also, ""with cancer treatments, it can be extremely dangerous to mix certain drugs, so there are genuine safety concerns behind these co-payment regulations…these days, people hear of drugs through the media which are hyped as miracle cures when really that not the case.””" Dr. Trask is an eminent clinician, and he has highlighted my point about the potential unintended consequences of simply changing law and policy in a way that some would describe as common sense and fair, but that others would define as opening a can of worms. Such a change might lead to a situation that would not be in the interests of patients and the NHS.