NHS Constitution for faster UK drug access?

The UK government has announced the drafting of a constitution to assert rights for patients under the 60-year-old National Health Service. According to the Secretary of State for Health, Alan Johnson, the core statement of intent is to reaffirm "the rights to NHS services, free of charge and without discrimination of any kind."

Among the promises being made by the government is a formal statement of the already-existing rule that local primary care trusts must provide drugs to patients when the National Institute for Health and Clinical Excellence (NICE) has recommended the treatment for people in England, Wales and Northern Ireland. In Scotland, this function is performed by the Scottish Medicines Consortium (Marketletters passim). There is also a commitment to speeding up the NICE's reviews.

However, where the NHS Constitution does appear to make clear that PCTs are obliged to explain any refusal to cover a drug in the absence of a directive from the NICE. One issue left unanswered is how patients will be dealt with who pay for drugs themselves that are not available to them in the NHS. The Constitution claim that patients will face no "discrimination of any kind" does not square with Mr Johnson's previous policy of excluding people who top up their health care privately (Markletletters passim).