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Liberal Democrats debate lift of ban on NHS drug top ups

November 5, 2008 3:14 PM
Originally published by UK Liberal Democrats

Speaking in the Commons, Liberal Democrat MPs deliver questions to Health Secretary Alan Johnson following the lifting of the ban on NHS 'top-ups'.

Liberal Democrat MPs warmly welcomed a statement from the Health Secretary, Alan Johnson, on November 4th that the ban on topping up NHS care by paying for drugs not available on the health service is to be lifted. The party had been calling for this to happen for some months.

"[T]he bottom line", said Norman Lamb, responding to the statement from the party's front bench, "is that we cannot justify a cruel and pernicious system that threatens to withdraw NHS care if a patient chooses to follow a clinician's advice in paying for a drug that is not available under the NHS." But, he said, "allowing top-ups must go hand in hand with reforms to ensure that access under the NHS is available to drugs that are routinely accessible in Europe but are not currently available in this country."

Evan Harris posed a series of questions to the Health Secretary about how the proposal would work in practice. He asked how he would deal with "the problem faced by someone who responds to a private treatment that keeps them alive but then runs out of money and finds that the drug is not allowed on the NHS because it worked for only a few people". Alan Johnson accepted that more work needed to be done on this and other questions.

Andrew George asked for reassurance that the NHS would "use its procurement muscle" when negotiating, in regard to the more flexible pricing arrangements being proposed, which would enable drug companies to supply drugs to the NHS at lower initial prices, with the option of higher prices if value is proven at a later date. He asked whether this would be a one-way street and, if the value is not proven, or if more drugs are purchased than anticipated, the price would go down. Alan Johnson said that that was a question for the National Institute for Health and Clinical Excellence (NICE).

Greg Mulholland asked whether, if someone started paying for a course of treatment, and NICE later announced that the NHS should fund it, they would get a refund. The Health Secretary said no, decisions would not apply retrospectively.

The final questioner was Paul Burstow, who pressed for greater transparency and accountability in NICE decisions. He asked the Secretary of State to "put it beyond doubt that he expects NICE to place all the models it uses in respect of decisions on appraisals into the public domain". Again, Alan Johnson said that this was an issue for NICE rather than him.