Top Up Payments

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2009 Health Care Service Group Conference
12 December 2008
Carried as Amended

This conference believes the introduction of top up payments for private treatments not available on the NHS will lead to a two-tiered healthcare system which already exists to some extent. This could lead to a situation where those who can afford to pay for the newer, more expensive treatments will get them and the poor will go without. The introduction of top up payments will further undermine the principle of healthcare based on need not ability to pay.

Conference notes that the National Institute for Health and Clinical Excellence is the body responsible for assessing drugs for use in the NHS. It is internationally respected and being used as a template for similar systems in other countries. Its assessment process is robust and results in a very small percentage of drugs being rejected for NHS use (around 5 per cent.). However, the speed at which the system operates could be improved and conference welcomes the commitment in Darzi’s NHS Next Stage Review to ensure this happens.

Top up payments will encourage private companies to offer insurance cover for treatments requiring top-up payments and this could become the norm as new drugs and technology becomes available. There is also a risk that drug companies will try and market treatments which are not of proven benefit.

The drug companies currently spend massive amounts on marketing far more than on research and development and at the same time make enormous profits from the NHS. This policy could also lead to NICE (National Institute for Health and Clinical Excellence) restricting new treatments in the knowledge that some patients would be able to buy them through top up payments.

Conference therefore calls for

1. The service group executive to continue opposition to the introduction of top up payments and to campaign against further policies aimed at introducing a two tier health service.

2.To continue to campaign for the speeding up of processes within NICE to enable a more rapid assessment of new drug treatments and a speedier appeals process when drugs are rejected on grounds of cost-effectiveness.

3. To develop a campaign to replace or restructure NICE to create a democratically accountable body made up of NHS staff, patients and the wider public.