Tuesday, 4 November 2008

Top Up Fees Are Rubbish

The government are planning on relaxing the rules on 'top ups' within the NHS. This is a stupid idea.

Let's forget about the inequity I've blogged on previously. These are more philisophical, I suppose.

Drug Companies are not good people. They're out to make money and they do it well. Given you have to speculate to accumulate companies spend more money on advertising than they do on research. Convenient, eh?

Making money and good ethics are seldom partners. If you want to sell things, you push them on people. If you want to sell pricey drugs which NICE have not yet certified as value-for-money, then what do you do? Advertise. Prey on people in very bad parts of their lives. Bad Karma from the Big Pharma. Although drug companies are not allowed to advertise directly to patients, as they are in the US of A and are restricted in advertising directly to GPs, the internet is a virulent tool. Such companies find other days of advertising their wares, and suddenly people are informed of treatments that their GP or other doctor didn't tell them about. They feel betrayed, even though the health care professionals were only trying to stay true to the four pillars of medical ethics:

# Beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
# Non-maleficence - "first, do no harm" (primum non nocere).
# Autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
# Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).

Drug companies are not pinned down by such pesky ideas. They can promise people pretty much the Earth, with some presentational caveats (i.e. spin). Such freedom must be quite liberating. But is free market economics the way for the NHS to go? I think not.

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