The Editorial says: The existing system allows patients to pay for extra treatment (top-ups) but then they lose all NHS care. 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."
It concludes: "Dignity and solidarity are key concepts that must be applied to NHS funding. The decision to allow a two-tier NHS is 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. The government needs to re-align its priorities, or face accusations of moral bankruptcy."
The Lancet, November 15th 2008, Vol. 372 No. 9651 p 1708
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