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Viagra Friday, 7 May, 1999, 16:11 GMT 17:11 UK
Keep on prescribing Viagra, doctors told
Doctors say government guidelines may still be arbitrary
Doctors are being advised to continue prescribing Viagra according to clinical need until the government's proposals become law.

The British Medical Association (BMA) has given a cautious welcome to the government's decision to extend the number of men who can get the impotence treatment on the NHS.

But it says there may still be some men who should qualify according to their clinical need who will have to pay for the drug.

For that reason it is advising its members to keep on prescribing Viagra on the NHS to anyone who they think needs it.

However, when the government's guidance becomes law, doctors are expected to conform.

Health Secretary Frank Dobson says he hopes this will be on 1 July.

A spokeswoman for the BMA said: "We believe that until things are in place legally, doctors would be flouting their conditions and terms of service if they did not prescribe Viagra according to clinical need."

'Arbitrary'

The BMA applauded the government's decision to refer its plans for Viagra for consultation with patients and health workers and for tackling the rationing issue.

But Dr John Chisholm, chairman of the BMA's GPs committee, said: "We welcome the fact that this is a longer list than was originally proposed, but it is still arbitrary and it will still exclude people who have a genuine clinic need."

He also criticised Mr Dobson's decision that men whose impotence is causing them "severe distress" will be eligible for NHS prescriptions only when they have seen a specialist for assessment.

Dr Chisholm said: "It is bizarre to oblige GPs who know their patients well and who are in a good position to assess their level of distress, to have to refer their patients to a specialist who doesn't know them as well.

"It undervalues the position of GPs and will overload the hospital system."

Mr Derek Machin, deputy chairman of the BMA's consultants' committee and a consultant urologist, agreed and added: "I also believe it sets a dangerous precedent for the NHS to select patients for treatment on the basis of the assumed cause of the problem.

"The effect of impotence on a man and his partner is the same whatever the cause of the condition."

'Discriminatory'

The Impotence Association said it was "disappointed" by the government's proposals, which it called "discriminatory and restrictive".

It said only 17% of impotence sufferers would qualify for NHS treatment.

"The new proposals do not take into account large numbers of impotence sufferers, for instance, those whose impotence is caused by cardiovascular disease or psychological causes.

"The Impotence Association feels that treatment for clinically-diagnosed erectile dysfunction should be available to all patients on the NHS, regardless of cause."

However, the NHS Confederation, which represents health managers, says the guidelines are "sensible and fair".

Stephen Thornton welcomes a "sensible and fair" decision
Chief executive Stephen Thornton said: "All publicly funded healthcare has to work within financial constraints and the government has recognised this.

"Priorities have to be set, because money spent on low priority areas is money not available for meeting higher priority needs."

Calling Viagra a "lifestyle drug", he added that the decision was "an important precedent for the future".

The confederation believes the new guidelines will add to the cost of prescribing Viagra on the NHS, but "only marginally".

"The threat of the NHS being overwhelmed by demand for Viagra will not now happen," said Mr Thornton.

Pfizer

However, Pfizer, the makers of Viagra, say the guidelines are "still unfair, discriminatory and arbitrary".

A spokesman said the group most affected by impotence are people suffering from cardiovascular problems, including high blood pressure.

These are excluded from Mr Dobson's list.

"These people are among the poorest in Britain and cannot afford to go private," said the spokesman.

See also:

07 May 99 | Health
07 May 99 | Health
10 May 99 | Viagra
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