|Debby Hirst was not
allowed to pay for a drug her doctor recommended. She did not have dominion
and sovereignty over her body the NHS did –
Her doctor was reprimanded for advocating for her and she was told she
would have to pay for all care for topping up
centrally planned systems – equally bad for all, subject to political forces,
violates subsidiarity. When she offered to buy it that is top up her doctor
was reprimanded and she was told if she paid for any care she must pay for
all.( the NHS philosophy is care based on need, not ability to pay.)
|LONDON — Created 60
years ago as a cornerstone of the British welfare state, the National Health
Service is devoted to the principle of free medical care for everyone. But
recently it has been wrestling with a problem its founders never anticipated:
how to handle patients with complex illnesses who want to pay for parts of
their treatment while receiving the rest free from the health service.
|Jonathan Player for
The New York Times
|Debbie Hirst with
her husband, Ian, on the beach at Carbis Bay in Cornwall, England.
government is reluctant to discuss the issue, hopscotching back and forth
between private and public care has long been standard here for those who can
afford it. But a few recent cases have exposed fundamental contradictions
between policy and practice in the system, and tested its founding philosophy
to its very limits.
|One such case was
Debbie Hirst’s. Her breast cancer had metastasized, and the health service
would not provide her with Avastin, a drug that is widely used in the United
States and Europe to keep such cancers at bay. So, with her oncologist’s
support, she decided last year to try to pay the $120,000 cost herself, while
continuing with the rest of her publicly financed treatment.
|By December, she had
raised $20,000 and was preparing to sell her house to raise more. But then
the government, which had tacitly allowed such arrangements before, put its
foot down. Mrs. Hirst heard the news from her doctor.
|“He looked at me and
said: ‘I’m so sorry, Debbie. I’ve had my wrists slapped from the people
upstairs, and I can no longer offer you that service,’ ” Mrs. Hirst said
in an interview.