Insurers eye NHS top ups market

By Graham Satchell
BBC News

Clive Stone has kidney cancer

The insurance industry has told the BBC if top up payments are allowed on the NHS the potential new market is "enormous".

The Association of British Insurers says private medical insurance could have a significant role to play in enabling patients to access new drugs and treatments not available on the NHS.

England's cancer tsar Mike Richards is reviewing the rules on top up payments and will report at the end of the month. The policy is also under review in Scotland and Wales.

I'll only be able to pay for two or three months worth of the drug Clive Stone Kidney cancer patient

Professor Richards has already met representatives of the insurance industry to discuss the policies they might provide.

Some new cancer drugs cost around £30,000 a year.

For patients like Clive Stone who has kidney cancer the drugs are out of his reach.

Even if the government gives the go ahead for top ups he would not be able to afford them.

"It's not the answer," he said.

"I can only talk about myself in this regard, but I'll only be able to pay for two or three months worth of the drug. On the fourth month I die. It's as simple as that."

Filling the gap

The insurance industry is getting ready to fill the gap.

Potentially the market is enormous Nick Kirwan Association of British Insurers

One private medical insurer WPA already has specific policies in place for top ups with names like "Health Top Up" and "My Cancer Drugs".

Policies which provide private cover for care not available on the NHS.

Only 12% of people in the UK currently have private health insurance.

But the Association of British Insurers is expecting that to change radically if the government does allow top ups.

Nick Kirwan, head of health at the association, said: "Potentially the market is enormous.

"All of us potentially might get cancer and may want to have these drugs.

"Without insurance there is very few people going to be able to afford these drugs and insurance is something that would make them available to just about everybody."

There is now consensus that if the NHS cannot afford new drugs then top ups may well be allowed.

But it is a decision that critics say may lead to a significant change in the way healthcare is funded.

If top ups are needed for other new treatments and drugs then private medical insurance may become much more common.