Is the NHS over?

"The following are the preliminary results of the survey we have been running in response to the private prescriptions debate  that has been raging on the blog. If you have missed out I would urge you to read the two posts below."

Post 1Private prescriptions within the NHS

Post 2Topping-up the NHS with private prescribing

"Only the minority seem to be acknowledging that MSers who want drugs outside of current NHS/NICE guidelines should be expected to pay for them. About a quarter are swing voters."

"The message is loud and clear at this stage that neurologists should be taking up the baton and introduce private prescriptions outside of NICE guidance. This has serious implications for the NHS and challenges its guiding principles; free and equitable access."

"This voting on this is tight. Does this indicate that socialist healthcare is dying? Can we resuscitate the principle? Can we prevent a 2-tiered system from developing?"

Some comments received that could feed the debate:

  1. "I think that it is ethical, because of the pressure that the NHS will be put under will make them more responsive to public desire for effective treatments. I think that it is unethical because it is unfair to those who cannot afford the treatments, not just in Britain, but in poor countries also."
  2. "I hate the idea but I hate the idea of getting worse even more."
  3. "Getting appropriate medical treatment should depend on need and not the size of your bank balance. I am firmly against any private medicine. I am sure America will welcome people with the ability to pay."
  4. "OK as it does not subtract from the 2nd tier users, only extend treatments to others."
  5. "My parents now live in France, where private medical insurance is necessary. A "basic level" - like the safety net to which you refer, but this can be expanded for those who want to / can afford to pay. The "basic level" seems to cover most drugs and services one would ordinarily need (inc. treatments for chronic leukemia , but increased cover is available. The system seems to work much better than some!"
  6. "But I want access to the drugs however - I've got ms!"
  7. "Well, thinking of the have-nots (me included) is dispiriting. Would it encourage profiteering?"
  8. "I think some of the NICE decisions not to prescribe don't seem to be rational. I am thinking of Fampyra here, which for a proportion of people is very effective and can help them stay mobile with all the fringe benefits that brings, e.g. reducing the amount of care and assistance that person needs, and potentially staying in employment. Surely the definition of a no brainer?"
  9. "Can't move research forward any other way. Fight on both fronts."
  10. "A real problem - who should control budgets, the NHS consultants/Trusts, GP's, parients? This is not really a stand alone MS issue and we need to make some painful decisions regarding what we spend our money on.The UK made its money in the 19th century and we have been spending it ever since and now it is gone. When I was growing up we saw poor countries such as India/China/African Countries having a real bad time, now it is our turn.We need cheap medicines that cure people everything else will be a question of personal wealth/insurance going forward."
  11. "2-tier system is probably unethical. However, it would be very unethical for a neurologist to withold treatment in order to be ethical."
  12. "My mother had MS and as a second generation MSer I have been unfortunate to not be able to AFFORD the luxury of private insurance."
  13. "The pot of money to treat patients is finite. More and more drugs continue to come to market that will help a person who is suffering, these cost money. People are living longer and need treatment."
  14. "The NHS is fantastic but some serious thinking is required. At some stage quite soon it will run out of funds and will be unable to exist. A way must be found to restrict expenditure but this is that that is a vote loser. What ever answer is produced is going to be unpalatable to some one or another."
  15. "I think we have got to restrict access to the NHS. Bone fide UK residents is a possible answer but is it workable? "
  16. "There could be definite benefits in some of these drugs, which will improve quality of life.
  17. The drug companies have agreed to cover a short trial to see if the drug has an appropriate response. Yet the NHS seem to be happy for any but the well-off to continue to suffer."

"We don't have enough response to be certain about these numbers. If you care about  the NHS have your say, by completing the survey."

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