By Nick Triggle
Health reporter, BBC News, in Edinburgh
Sue Matthews is terminally ill
As doctors prepare to debate the issue of NHS patients paying to top up their care with private treatment, one surgeon says the experience of his wife has left him convinced the practice should be allowed.
So-called co-payment is perhaps one of the trickiest questions facing the NHS at the moment.
Guidelines suggest that patients should lose their right to NHS care if they pay for drugs privately to top-up their care. But many think this is unjust.
Gordon Matthews is a leading orthopaedic surgeon, but he has found himself facing the same dilemmas as any other member of the public would in caring for his terminally ill wife.
Sue, 57, was diagnosed with bowel cancer four years ago and has since faced a number of operations and chemotherapy treatment in a bid to fight the disease.
She is now in the final stages and has perhaps just months to live.
There is little more the NHS can do for the Buckinghamshire woman so the couple are now considering whether to pay for a drug called cetuximab, which could help prolong her life for several months.
But as it is not funded by the NHS, the couple could fall foul of the ban on so-called co-payments.
"We don't yet know whether it will mean we will be excluded from the normal package of NHS care," says the 59-year-old Mr Matthews.
"It would cost £30,000 for a course of the drug, which fortunately we can afford.
"But if we then had to pay for the normal NHS care after that such as the scans and drugs we are currently having, we would probably have to sell up our house.
"I think at that point Sue would say no as she would not want to do that to her family.
Sue has advanced bowel cancer
"We are clutching at straws. The drug could prolong her life so of course we want it, but it is wrong we are left it this situation.
"We have not asked our local health trust what they would do, but I think we are approaching that point where we will have to.
"As a doctor, I could have afforded to pay for private cover, but I didn't as I believe in the NHS.
"I accept there has to be a threshold and that the NHS cannot afford to pay everything. But why should we be penalised if we want to pay for drugs not available?"
Critics of co-payments have suggested it could create a two-tier NHS because there would be preferential treatment for those who could afford it.
But Mr Matthews said: "You have to be realistic. It already happens. People pay for scans, pay for physio. You cannot stop it.
"As long as we decide on the level of care that should be provided by the NHS and that is provided free then patients are not prejudiced against.
"On the contrary, what you get is an increasing database of evidence on whether these drugs work. That could help in future assessments."