Thursday, 3 July 2008

Co-payments: I don't understand

by Charles Pooter

Pollard has posted to CIF about "co-payments". For our colonial and foreign readers, my understanding of this rather arcane detail of Britain's Stalinist healthcare system is as follows:

The state has an approved list of drugs that its guild-recognised healthcare minions can prescribe to patients with serious conditions. The list is based on medical effectiveness and supposed value for money. In other words new patented drugs can be expensive, demand is potentially unlimited and cash supply is limited by the Exchequer. Essentially, it is the historically common way that central planners attempt to introduce a smidgen of economic sanity to a supply mechanism with no price signals: rationing.

Anyway, some people with fatal diseases have wanted to "top up" their state-approved meds with privately-prescribed drugs that the relevant QUANGO has not yet sanctioned. The state finds this unacceptable and, wanting a level playing field in death, threatens to withhold the state-mandated drugs from anyone who augments them with a private prescription.

But, I just don't get it. If I have cancer and I'm getting a regular NHS prescription for Genero-drug and then one day my Doctor says "The Genero-drug is working quite well, but did you know that there is another drug named Expensicillin, which may help with your condition even more. Unfortunately it has not been approved by NICE yet, but I can give you a private prescription." What I don't understand is this: how does the NHS know that I'm getting the private prescription as well as the NHS one? Surely the only possible way the NHS could know is if my Doctor tells them.

But wouldn't that be a total betrayal of Doctor-patient confidentiality?

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