The Royal College of Nursing (RCN) has said the Government must work with health professionals and patients to ensure that the introduction of top-up payments does not result in a two tier NHS.
The comments were made as the RCN responded to draft Department of Health guidance on NHS patients who wish to pay for additional private care in England. The RCN consulted with its members before contributing to the Government consultation and has recommended that top-up payments are permitted but only for a limited time, until the full implications were investigated. The College expressed concern that unfettered top-up care may have a big impact on the founding principles of the NHS. This, the RCN says, is why the Government must be clear in its decision about how top-up care works in practice and why careful monitoring is required after implementation. The College has warned that changes must not be rushed to ensure that the full effects are understood before a policy is permanently applied. RCN chief executive and general secretary, Dr Peter Carter said: “We do not want to face a situation where two patients in neighbouring beds can be offered different menus of treatment, based solely on their ability to pay. The Government made the right decision in November in lifting the ban on top-up payments while examining the full implications of the policy, and I am pleased that many nurses took part in our consultation on that issue. If a patient decides to top-up their care, will they be taking NHS services and facilities away from other patients? Will a Trust in the South of England be able to offer patients the same options to top-up as a Trust in the North of England? The Government needs to carefully avoid the creation of a deep and complex postcode lottery.”
