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Topping up your NHS treatment with a bit of private is against the law - I didn't know this until now, it's ridiculous, care to discuss?

74 replies

Thomcat · 14/10/2008 10:33

I've just been listening to BBC London and they were discussing, in relation to cancer treatment in this instance, that, if you have been receiving treatment on the NHS for x amount of time and then you hear about a drug that is available that might help and you pay for it, in addition to the treatment you are getting on the NHS, you are then given a bill for all treatment you have received thus far on the NHS. If you don't put your hand in your pocket and pay for this additional bit of medicine then you just keep receiving the free NHS treatment with no problem.

How outrageously unfair is that [cross]

Apparently there are 30 hospitals in the UK that are allowing this to happen. Not sure how, by turning a blind eye mainly I think, or by saying if they take this paid for drug home it?s a separate thing and these hospitals are getting round it that way. But it?s not legal and it?s only about 300 hospitals turning a blind eye.

What a ridiculous and unfair, disgusting ?law?.

Why should you not be able to top up your NHS treatment with a bit of private by being able to afford a drug that might help you?

Discuss????????

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Thomcat · 14/10/2008 10:35

Oh apparently this is just for cancer patients.
So if you are receiving cancer treatment on NHS you are not llowed to top up with privatley bought bits of treatment.

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megcleary · 14/10/2008 10:37

as a nurse can honestly say we are v pissed off with the situation and constantly trying to find ways around it

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curlywurlycremeegg · 14/10/2008 10:37

It is stupid (sorry that's not a great word I know). I am worried how this is going to equate to women who chose an Independent Midwife in the future. At present they are still entitled to scans, blood tests and emergency treatment on the NHS, after all they are saving the NHS money in the long term. However if they are seen in the same light as patients under this rule women's choice will be put under even more pressure

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DraculaNeedsArteries · 14/10/2008 10:37

That is shit.

Especially if it only erlates to cancer patients.

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curlywurlycremeegg · 14/10/2008 10:39

Sorry I just re read my post and it looks like I am only bothered about pregnant women, of course I am not, the rule sucks on a whole, whoever it is actioned and aimed at.

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Thomcat · 14/10/2008 10:40

It's just ludicrous.

Apparently there have been cases where a dying man had been bought a drug privatley to make his last days more comfortable and the family have then been given a bill for £30,000 for the treatment he had been receiving on the NHS.

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CaptainKarvol · 14/10/2008 10:41

You can't top up in all sorts of circumstances, or at least you can't part-fund treatments.

The best argument I can come up with at the moment for the status quo is what happens if treatments are not quite that cut-and-dried?

Pay for your own tablets seems fine - you want them, you buy them.

But who then pays for any extra monitoring you might need, any adverse consequences of the private treatments, the consequences of any drug interactions?

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Thomcat · 14/10/2008 10:41

Have a look at this website Doctors for Reform

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mabanana · 14/10/2008 10:43

It is terrible, wrong and really shocking IMO.
Parents of children with SN like me are constantly 'topping' up NHS care with private speech therapy/OT assessments etc. SHould that mean that we don't get any NHS care?? It completely wrong.

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nooname · 14/10/2008 10:44

I think this rule will be changed soon as it is so unpopular and doesn't exactly fit with the Government's whole patient choice thing.

It's also possible that it might conflict with Articles 2 or 8 of the European Convention on Human Rights so it would be very interesting (at least for me from an academic perspective anyway!!) if someone brought a legal case under the Human Rights Act against their Trust.

Particularly given, as has been commented, that it seems only to be applied to cancer patients and thus could be seen as discriminatory.

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Thomcat · 14/10/2008 10:45

It would mean that yoou get that NHS treatment still but you'd be faced with a bill for anything you had received and would be treated as a private patient from the second you had walked into that hospital. Any treatment you had already received on the NHS you would be billed for!

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nooname · 14/10/2008 10:46

Also, the fact that it depends on where you live could also be a big problem under the ECHR.

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SaTanicGore · 14/10/2008 10:46

I don't think it is only cancer patients, just that they are more likely to require drugs which are not given on the NHS because of budgets

This was highlighted in the press last year (Avastin for breast cancer is a common one).

The Department of Health said: ?Co-payments would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.?

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Thomcat · 14/10/2008 10:48

I'm just gobsmacked I re4ally am. I can't believe this is a law thatapplies to a cancer patient

You're suffering, in pain, paid into NHS all your life, you use to life savings to pay for a drug that will ease your pain and possibly give you longer to live and suddenly you have to stump up for all the treatment you've received. No way, that's just not on. I can't believe it.

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Thomcat · 14/10/2008 10:50

I get that the 2 tier thing would be bad and apparently there is talk of a charity being set up that people can use if they need these drugs unavailable on NHS.

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Anna8888 · 14/10/2008 10:53

I don't know why someone doesn't take a case like this to the Court of Human Rights.

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nooname · 14/10/2008 10:57

Anna8888 - they would need to bring the case in the English courts under the Human Rights Act 1998 first otherwise it would be rejected by the Court of Human Rights.

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Thomcat · 14/10/2008 10:57

I know. How long has this been going on and how many people have been affected by this?

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Anna8888 · 14/10/2008 10:58

And can't someone do that?

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edam · 14/10/2008 10:58

I've heard of someone who only got the drugs he needed - and that lengthened his life considerably - because his employer covered the costs. Shocking. Other people diagnosed at the same time who didn't have access to those drugs died much sooner.

However, there is a real problem about creating a two-tier system where people who can raise money to buy drugs not available to other patients get better treatment. I don't know what the answer is - abolish NICE so everyone can get the drugs their doctors prescribe? Better negotiation between NHS and drug companies so new medicines aren't so bleeding expensive in the first place (yes, I know R&D costs money, but pharma cos spend MORE on marketing)?

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edam · 14/10/2008 10:59

Problem is we are generally talking about the terminally ill here and someone who is dying is not usually going to spend their last days fighting through the courts, taking time and energy away from their family. Hideous catch 22.

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nooname · 14/10/2008 11:01

Edam - the thing about not wanting a two-tier system is that you are effectively forcing everyone to accept the lowest-common-denominator of care. Ie, because some people can't afford extra care then no-one should get it.

That actually benefits nobody. It doesn't make a blind bit of difference to someone who couldn't afford to top-up that someone else is prevented from doing so. (Unless of course we actually see this as an underhand way of saving the NHS money - but that is not how it is being explained by the DoH.)

The only people who are ok in the current scenario are those who are so rich they can fund everything.

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Anna8888 · 14/10/2008 11:02

But there is already a two-tier system in the UK.

For example, my mother broke her arm about a month ago. She went to A&E and had it x-rayed and put in plaster. Two weeks later she went back to have it x-rayed and hopefully put in a lighter cast, and it was found that her arm wasn't healing. The NHS hospital wanted to operate and pin her arm.

My mother was very anxious and called the local private hospital where, within an hour, she had spoken to a hand surgeon who was able to call up her x-rays (from two different NHS hospitals within the same trust), do a diagnosis by telephone, tell her what operation she ought to have for best outcome (none or a plate, but not pinning) and give her an appointment to see him the next day and for an operation three days later (after the weekend).

So my mother had the private op. No problem there.

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nooname · 14/10/2008 11:06

The NHS does have to make difficult decisions regarding what they spend their money on - they don't have a bottomless pit of money. Their argument is that these cancer drugs are not cost-effective when you take into account their cost versus the extra time/quality of life they provide.

But, I heard a radio interview with a cancer specialist and he said that the UK cancer specialists are looked on with pity by the rest of the developed world as we have such a relatively low spending per head on cancer drugs.

Ie - maybe NICE has made the wrong decision over funding some of these drugs - certainly other countries appear to have made different decisions. They apparently amount to a pretty small proportion of total NHS drug spending (sorry about lack of detail, I am remembering from an interview a few months ago!)

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CaptainKarvol · 14/10/2008 11:07

This is always going to be the issue with the NHS isn't it? You can see, clearly, who can't have what. Any other system, those who can't have expensive drugs and treatments are hidden from public view. The NHS is expected to provide everything that everyone wants. You have to make choices in that system. You have to ration. There isn't enough money anywhere to provide everything for everyone, and there isn't going to be.

Rationing should be fair, it should be transparent, but it can't not-happen.

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