Stazjia’s Commentary

Of course we are very lucky here in the UK to have a National Health Service (NHS) that is “free at the point of need.”

The problems start as more advanced treatments come on the market for life threatening illnesses like cancer because many of them are extremely expensive. There is a limit to how much tax the government can impose to pay for the NHS and the budget still has to be found for all the existing treatments and other expenses.

Because the NHS is administered regionally, we have now entered an era of ‘postcode lottery’. People in some areas can get an expensive drug to treat their potentially fatal cancer while people in the area next door can’t. To complicate the situation, at present, patients can’t pay for the extra drug themselves and continue to get free NHS treatment and other drugs they need. If they pay for one drug, they have to pay for everything including doctor’s consultations, hospital stays, etc. It’s only the wealthiest people who can afford to do this or those with very good and expensive health insurance – quite rare in this country.

Some people can raise the money for the expensive drug denied them by their local health authority, maybe by remortgaging their homes, taking out a bank loan or some other means. Because of the rules, though, they can’t do it without sacrificing the rest of their treatment.

It’s come to the point that people die because they are denied life-saving treatment and they and their families have to live with that knowledge as the disease progresses.

There has been a big outcry in England about this and opinion now seems to be swinging in support of allowing people to pay for the extra drugs without losing the rest of their NHS treatment. The same debate is taking place in Scotland where the NHS is administered by the Scottish Parliament. There the debate seems to be going in the opposite direction. The argument against allowing paying for some treatment is that, first, “the NHS is free at the point of need” and second, it gives better off patients an advantage against poorer ones and so makes the NHS unfair. The whole point being that the health service is supposed to iron out inequities between people with money and those without.

I can see both points of view. Why should some people be allowed to die because they can’t afford to pay for extra drugs but why should everybody be allowed to die who could benefit from new drugs because they aren’t allowed to pay for just the ones the NHS can’t afford?

I suppose that, in the end, there is no advantage to letting everybody die when some could be saved – denying the more prosperous treatment won’t help the poorer patients. The terrible thing is that this is the kind of dilemma that the NHS was supposed to stop happening.