Top up payments for drugs likely in England. In Northern Ireland, is anyone interested?

Update It seems nobody is interested- amazing! Some things are a matter of life and death and some things are more important that that – like sectarian knockabout.

Here’s a real life and death issue I haven’t seen discussed by local ministers. “The current practice on top-ups, which prohibits people from privately purchasing drugs not available on the health service while continuing a course of NHS care, is untenable. People could not understand why they are allowed to top up NHS optical or dental care, but refused treatment if they use their own money to buy a drug that might prolong life.”

So says Niall Dickson the notably level headed director of the prestigious King’s’ Fund arguing for top-up payments which now look likely – at least in England. What about Northern Ireland?. But there’s another equally passionate point of view.

“Professor Martin Gore, medical director at the Royal Marsden Hospital in London, said there was a “quantum difference” between paying for cancer drugs, which could be required for months or years, and paying for one-off items such as dental crowns. Many social groups such as pensioners were not going to be able to afford the drugs. “Is that a deserving end for people that have given to the NHS all their lives? Is that what pensioners deserve?”

The current rules say you cannot mix NHS care with private care.If you “top up” your NHS care with a cancer drug you have to go totally private.

A partial solution is offered in the Times, “a supplementary insurance market that will create a reliable, easy and affordable way for people to access all forms of treatment. This has happened in other countries, such as France, Switzerland, the Netherlands and Israel, where they have quite a big supplementary insurance market..

But what if you can’t afford insurance? That’s where a new means-tested charity could step in.

The rule applies across the UK and the Northern Ireland and Wales administrations said they would watch with interest the developments in England. Scotland has already announced a review, although it is specifically on cancer drugs. According to a BBC report, the expectation is that the Scottish National Party government will stay with the status quo and not allow so called co-payments.

This is now a devolved issue. I haven’t been able to find any sign of “watching with interest” in the Assembly. I’d be delighted to be proved wrong. Over a very expensive issue of life or death, what are they going to do?

Former BBC journalist and manager in Belfast, Manchester and London, Editor Spolight; Political Editor BBC NI; Current Affairs Commissioning editor BBC Radio 4; Editor Political and Parliamentary Programmes, BBC Westminster; former London Editor Belfast Telegraph. Hon Senior Research Fellow, The Constitution Unit, Univ Coll. London