Review of co-payment rules welcome - the challenge must be to preserve basic NHS principles, says The King's Fund

Commenting in response to the announcement today that Professor Mike Richards, National Clinical Director for Cancer, will lead a review of co-payments for patients choosing to pay privately for drugs that are not funded on the NHS, King’s Fund chief executive Niall Dickson said:

'We welcome this review – this issue will not go away. In the face of rising demand and finite budgets it is something politicians and indeed the rest of society must address.

'Nor is it straightforward – the challenge is to protect the overall integrity of our current funding system, while seeing if there are ways of accommodating a small number of patients in extreme cases to top-up their care. This has obvious implications for an NHS which is based on need not ability to pay, but it does seem as if there will increasingly be cases where it is hard to justify withdrawing NHS treatment just because someone wants access to a particular drug or procedure.

'The review should ensure that the NHS is compensated for any associated costs incurred and also consider the impact on patients who cannot afford top ups.

'The review should also consider how patients and their families – often at desperate times in their lives – are able to make informed choices based on a full understanding of both the benefits and the possible downsides of any drug.'

He added: 'The scope of this review only covers drugs and not medical devices, such as more expensive replacement joints, limbs or implants such as lenses. These are all areas where the issue of top-ups may arise and it does seem a missed opportunity not to have included them in the review.'

Notes to editors: 

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