According to an editorial published in this week’s Lancet, the National Health Service (NHS) in the UK has made an ‘undignified’ and ‘divisive’ move by allowing patients to ‘top-up’ their free NHS treatment with treatments that are not currently approved by the NHS.

“The existing system allows patients to pay for extra treatment (top-ups) but then they lose all NHS care.” explain the authors. “The new proposal, which is out for consultation until January, will allow top ups, with the rider that the extra treatment cannot be given on an NHS ward but will need to be administered in a private ward or hospital. The UK Government is clearly embarrassed, not wanting patients in adjacent NHS beds to be receiving different care.”

The editorial writers believe that NHS funding must be based on dignity and solidarity, and they label the new two-tier NHS as ‘undignified’ and ‘divisive’.

“The National Institute for Health and Clinical Excellence, battered this year for its decisions about high-profile drugs for renal and lung cancer, and dementia, is to review how it calculates whether a treatment is cost effective. But the funding of a national health service reaches higher, to the heart of government. This summer saw the UK Government use £400 billion of taxpayers’ money to rescue ailing financial institutions. Vast sums of money can be made available when needed,” conclude the writers.

The editorial adds that if the government does not re-align its priorities, there will be accusations of ‘moral bankruptcy’.

A morally bankrupt government divides the NHS
The Lancet (2008). 372[9651]: p. 1708.
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Written by: Peter M Crosta