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Those interested might also read the report on top ups of the Select Committe on Health of the House of Commons I confess I was one of their advisers!) On Jul 13 2009, A. Tawfik-Shukor wrote: >Many of you will be interested by the new BMJ analysis by Ellen Nolte et al >(abstract below): > > Desai M, Nolte E, Mays N, Nikolentzos A. *International experience of > paying for expensive medicines*. BMJ. 2009 May 29;338:b1993 > >Abstract: > > The use of so called top-up payments for drugs that are not available on > the National Health Service has caused controversy. Some people believe > that it will result in increased access to medications while others warn > that such payments contradict the founding principles of the NHS and may > lead to greater inequalities. Mike Richards's review Improving access to > medicines for NHS patients and the government's response to the review > have acknowledged that additional payments, which are already used in a > non-uniform manner, must be accepted into practice. The review does, > however, recognise that the right to pay for additional specialist care > that is not funded by the NHS should be invoked rarely so as to minimise > compromising the founding principle of the NHS-namely, to provide a > comprehensive service to all on the basis of need, not ability to pay. > > The Department of Health has set out a series of safeguards to ensure > that patients opting to pay for additional private care do not lose their > entitlement to NHS care while minimising the risk of public funds being > used to subsidise private care. We discuss some of the challenges posed > by these new proposals and their implications for the NHS against the > background of international experience.