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The health secretary is standing firm against demands to end a rule he imposed last year that means people who privately buy drugs not available on the National Health Service, a principle known as co-payment, must be refused all NHS care for their condition.
From the office of Alan Johnson, secretary of state for health Dear Mrs Wilson, I am sorry to hear about your cancer. But I would like to take up a few minutes of your fast-ebbing time to reassure you that, even though my decision to refuse you NHS care if you insist on paying privately for a drug may shorten your life, it really is for the best. I recognise that it may not seem that way to you, but then again you are rather ill and so not in the best state to judge. Strictly speaking you are right to say that we could keep you alive if we provided the standard NHS care for which you have paid all your life and let you go private for the drugs. But I think you are allowing your imminent demise to obscure the bigger picture. You really do need to consider the wider interests of the NHS. A million people are being treated successfully on the NHS every 36 hours. It's just that you aren't going to be one of them. You say that a course of Extenda could allow you to live long enough to see your children into their teenage years. I have to tell you that our clinicians at the National Institute for Clinical Excellence feel that this is not an efficient use of our money - and frankly they are the experts. In your letter, you point out that you have paid for the NHS your whole life. Well then, surely, you wouldn't want to see your taxes wasted. I have to weigh your desire to see your children past puberty against the fact that many people cannot afford this option. Since they cannot survive, it is clearly in the public interest you shouldn't either. In any case kids are very resilient; I'm sure they'll get over it. Far better to lose a parent than keep a mother who carries the stigma of having betrayed the founding principles of the NHS. You have argued that the very rich are unaffected by this ban on NHS treatment since they can afford full private healthcare. I agree that this is reprehensible. If the rich had any social conscience they would die like the rest of us and not use their wealth to play the system. But while, sadly, I cannot stop these rich death dodgers, I can ensure that those on middle income don't cheat the reaper. I must also ask you to stop this press campaign. Please bear in mind that you will soon be dead but that we as a government will have to live with the consequences of your meddlesome and rather unfraternal campaign long after you are gone. Many people in the same position have met their fate rather more stoically than you. Whatever happened to Dunkirk spirit? Alas, I cannot tell you that your death will help thousands to live, but I can reassure you that it will allow thousands to die in the same way. It is not just the principle. Have you thought through the consequences of unnecessarily extending your life? We will have to treat you for longer and you are bound to get ill again. If the cancer doesn't get you, something else will. Is it worth the cost to the state just to put off the inevitable? Remember, if you stick with the NHS you can rest assured that you will die at the hands of a health service that is the envy of the world. Wishing you all the best for a speedy demise. Yours sincerely, Alan Johnson
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