Most support private `top-up' cancer treatment pilot scheme

A majority of submissions support a proposed pilot scheme allowing private "top-ups" in Otago and Southland for those who can afford to pay for unfunded cancer treatments.

The Otago and Southland district health boards invited submissions on its Bridging the Gap consultation paper, which proposed a pilot scheme allowing cancer patients to receive publicly funded treatment, while paying for extra unfunded drugs.

If successful, the top-up programme might be expanded to other departments.

A summary of the submissions is to be presented to today's hospital advisory committee.

The committee would consider whether to recommend the boards implement the pilot scheme.

Some cancer patients at Dunedin Hospital had already paid for unfunded treatment with the consent of senior management.

Unfunded intravenous drugs can be administered after 5pm if patients pay, but the approach to such treatments has been inconsistent.

The boards received 100 submissions on the proposal, including 49 from district health board staff.

Of the submissions, 58 either agreed or strongly agreed with the proposal, while 38 either disagreed, or disagreed strongly.

Of the district health board staff's submissions, 30, or 61%, agreed or strongly agreed with allowing paid top-ups, while 17, or 35%, either disagreed or strongly disagreed.

Eighty-four submissions were from individuals, while 16 were from organisations.

A report summarising the submissions says the issue was misrepresented in a media debate wrongly raising the spectre of private wings in public hospitals.

The report says a principle-based approach to the pilot would ensure ethics were not breached, and non-paying patients would not be discriminated against.

Concerns expressed in submissions included that the proposal undermined the public health system; it represented the ushering in of user-pays; that it would undermine the buying ability of Pharmac; and that it would lead to unequal treatment of paying and non-paying patients.

Some submissions also raised concern about financial liability to the boards, which the report says will be offset by careful planning.

Supporters cited patient choice, patient rights, the top-ups' affordability compared with all-private care, continuity of care and job satisfaction for health workers.

The pilot could encourage health staff to stay in the public sector by giving them experience in cutting-edge treatments and programmes, supporters say. - Eileen Goodwin.