Scottish Government
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Review of co-payment guidance
There will be a review of the guidance governing co-payments - the ability of a patient to access treatments not available in the NHS in the private sector while concurrently receiving the rest of their treatment on the NHS.
Speaking ahead of a Public Petitions Committee sponsored debate in the Scottish Parliament today, Health Secretary Nicola Sturgeon acknowledged that the issue was difficult and controversial but pledged that new guidance would seek to combine the rights of the individual with robust clinical governance and the founding NHS principle that treatment should be based on clinical need not on the ability to pay.
She also stressed that the discussion around co-payments should not deflect attention from ensuring equitable and increasing access to new drugs on the NHS. Under current arrangements, where a drug is shown to be clinically effective and a good use of NHS resources, it should be available on the NHS.
Ms Sturgeon said:
"The time is right to review the guidance on co-payments and I have undertaken in my response to the Petitions Committee report that we will do so.
"In making that commitment it is, however, important to highlight a number of points.
"Firstly, cases where co-payment is even an issue should be the exception not the norm. Our key focus should be on ensuring equitable and increasing access to new drugs on the NHS. The principle of NHS care available according to need not the ability to pay is one that I - and all of Scotland - hold dear.
"Secondly, it is an important principle that the NHS cannot charge patients to provide treatment that would not otherwise be available on the NHS. However, patients do have the right to access care from the private sector. The question then is to what extent such privately provided care can be concurrent with care provided on the NHS.
"Essentially this has to be considered on a case by case basis. In situations where the treatment to be provided privately is so interwoven with NHS treatment that there can be no clear delineation between the two, concurrent treatment would create a lack of clarity with implications for patient safety, clinical accountability and probity. In such circumstances, concurrent treatment would not be appropriate.
"However, where different elements of care were able to be separated safely, concurrent care may well be possible.
"These are complex judgments and the purpose of the revised guidance will be to provide clinicians, NHS managers and patients with the right framework for making these decisions."
Related Information
http://www.scottish.parliament.uk/s3/committees/petitions/index.htm
