By Graham Satchell
Should patients be able to top up their treatment by buying new drugs that aren't yet available on the NHS?
Debbie Hurst cannot get a vital drug
It has become a live issue as more drugs come on to the market, and more patients use the internet to research them.
Debbie Hirst has breast cancer which has spread to her liver and bones.
Debbie lives in Cornwall and she has been fighting to get a new drug, Avastin which has produced results in clinical trials suggesting it may halt the growth of tumours.
Avastin has been licensed but it is not available on the NHS.
The National Institute for Health and Clinical Excellence has yet to decide whether it should be made available to patients with advanced breast cancer, although it has not recommended it for treating advanced bowel cancer.
Debbie says it was her consultant who suggested a solution.
"My oncologist said it would cost about £60,000. There is no way they would fund it, so we said can we fund it ourselves? The answer was yes."
Debbie started saving, she put her house on the market.
But then came guidance from the Department of Health. If Debbie paid for Avastin she would have to pay for all her treatment.
Debbie says she was furious.
"I was heartbroken because I thought it was cruel and rotten. There's a drug there, but I can't have it because it is too expensive. If I can fund it why can't they accept that money?"
The government says the rules on this are clear. You can't mix and match between private care and the NHS.
You either go all NHS and it is free, or you go all private and you pay for everything.
A Department of Health spokesman said: "If those who can afford it start "topping up" their care it will create a two tier NHS. What about those who can't afford Avastin?"
Debbie has instructed solicitors in Manchester to take her case to judicial review and she's determined to go to court.
Melissa Worth, from the law firm Halliwells, said: "There is nothing in law to say the Trust can't allow you to pay privately for the drug to top up the NHS treatment you are receiving at the moment."
Other patients get drug
What makes things worse for Debbie is there are already three patients in Cornwall who are paying privately for Avastin and being treated on the NHS.
Debbie is determined to keeping fighting for Avastin
Rob Pitcher, the medical director at Debbie's hospital the Royal Cornwall Hospitals Trust, said: "We do have established co-payment arrangements with a very small number of patients that were begun before the trust received recent guidance from the Department of Health, and for whom it would be unfair to now withdraw that arrangement."
He went on to offer some hope for Debbie saying there would be a special review of her case.
"In Mrs Hirst's case, if her review is successful, there will be there will be no need to consider a similar arrangement as her treatment will be entirely funded by the NHS."
Debbie knows she may only have a few months to live. The reason she is fighting so hard is because she believes Avastin could give her more time with her family.
"I've done research on the drug I feel that this is something that could possibly extend my life and if i'm prepared by hook or by crook to get the funding together then i should be able to have that chance."