Tuesday, 4 November 2008

Topping-up the NHS??

. Back in the UK now; the government today said it would allow paitents to 'top-up' without losing their basic NHS care package. Nick Clegg has welcomed this in the Guardian; calling it a step towards a more 'liberal' NHS.

It is welcome that Clegg recognises the problematic side of this decision and sees the challenge as being to;

"avoid this undermining the important principle of equity and to ensure that it goes hand-in-hand with much-improved access under the NHS to life-saving drugs routinely available overseas."

This is the paradox that this decision places upon supporters of the principles behind the NHS. On the one hand, yes it is wrong to take peoples care away from them but on the other what does need to be avoided is a 'two-tier' NHS. The governments solution to this paradox is to simply remove the people who are 'topped-up' from the same wards as ones who are not; out of sight, out of mind they figure. However, this is demonstrably not going to work.

What we have is a classic fudge because all this ruling means is that people will be able to receive the NHS care but not have to pay for the drug. However, they will still have to pay for the staff hours etc, etc; so in actual fact they will not be saving alot. Pharmaceutical companies will be encouraged to give better prices to the NHS by taking part in so called 'risk-sharing' models. It is the prices these companies charge that are the root cause of this problem and are a significant burden on the NHS; and they are what undermines the principles that Nick seems rightly keen to defend. It is these that arbitrarily decrease choice and put the NHS in an invidious position; if you want the nub of what lies at the roots of 'two-tierism' in the NHS then here it is.

A couple of months ago the chairman of Nice spoke to The Observer and warned that the;

"drugs industry is overpricing vital new medicines to boost its profits"

and went onto say;

"Marketing costs generally are about twice the spend on research and development."

So, it is not enough to call for protection;

"from pressure from drugs companies"

as Nick does. Our party should be the one that grasps this nettle and says quite clearly that practices which inflate the pricing of medicines will not be allowed. This is the only way for Nick to defend the values he speaks so eloquently in favour of in his article.

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