The government’s decision to allow co-payments for private treatments assumed it is best to make expensive drugs ‘as freely available as possible’, MPs have been told.

At the opening of an inquiry into the controversial policy, Birmingham East and North primary care trust chief executive Sophia Christie told the Commons health committee that national cancer director Mike Richards’ review of co-payments had “sidestepped” important areas of the debate.

“The underlying assumption is that it’s bad to say no to certain drugs and we need to make as much as possible as freely available as possible.

“That seems to me to sidestep the issue about public investment health gain,” said Ms Christie.

She criticised the National Institute for Health and Clinical Excellence’s decision to change the threshold it uses to assess the cost effectiveness of some drugs, saying it could divert cash away from services such as palliative care.

Postcode lottery

NICE revealed the plan alongside Professor Richards’ review, publication of which in November triggered the inquiry.

Challenged over the “postcode lottery” caused by different PCTs making different commissioning decisions, she said a network of public health consultants was being established to share findings on drugs.

But Liberal Democrat committee member Sandra Gidley criticised the current system as run by “self-selected people making decisions”.

“What we’ve highlighted is the system is a complete mess,” she said.

Billing worries

The committee also heard that separating privately bought and health service care, as proposed in the review, would cause huge data and billing problems for trusts.

Medical oncologist Alison Jones of the Royal College of Physicians said it would be almost impossible for trusts to link seriously ill patients’ side-effects to the privately bought drugs that caused them, meaning the NHS would pick up the bill for alleviating them.

IT links

And she said private hospitals administering drugs would need links to health service hospitals to be able to communicate about test results, leading MPs to suggest private hospitals might even need to join the NHS IT system.

Dr Jones recommended that top-ups should be given in NHS hospitals but administration should be done separately.

But Newcastle upon Tyne Hospitals foundation trust chief executive Len Fenwick said patients asking for drugs not available on the NHS was a “rare event” at his hospital which could be managed through discussions with patients.

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