Yesterday, I attended a magnificent event hosted by the private medical insurer Western Provident Association

They had hired Britain’s leading health lawyer, Nigel Giffin QC, to provide a definitive view on people’s legal rights to NHS treatment and care.

It was a fascinating meeting which made it clear that people living in England and who face huge medical bills because they cannot get life-saving drugs on the National Health Service, could benefit by moving to Scotland for treatment. The issue arises because cancer patients in Scotland can be prescribed on the NHS one or more of 19 life-saving or life-prolonging drugs that are denied to patients south of the border. In addition, two drugs that can prevent blindness in some cases are available on the NHS only in Scotland. Nigel Giffin, QC, said: “I might ask as a resident of England, what can I do to take advantage of the favourable regime in Scotland. It all hinges not on what is under your kilt, but where you are ordinarily resident. To be ordinarily resident for the purposes of healthcare in Scotland, residency does not have to be permanent.” He continued: “You can be in two places at once. If you are called Gordon and you’re in London four days a week and the rest in Scotland, are you ordinarily resident in two places at once.”

Polls carried out on behalf of Western Provident Association show widespread disapproval over the Scotland/England split on access to medicines. Nine in 10 thought it “unacceptable” that people in some parts of the United Kingdom were able to get drugs on the NHS while others were not. Similarly, nine in 10 MPs of 97 polled, representing a cross section of the Commons, also thought the anomaly was unacceptable.

Almost a third of the public – 29 per cent – thought they did not have a legal right to use their own money to top up NHS treatment by buying drugs not available on the NHS.   A slight greater proportion of MPs – 31 per cent – thought likewise. 

A total of 21 drugs are available on the NHS to people living in Scotland. The list includes cetuximab (brand name Erbitux) for stomach cancer at £3,685.50 a month, which was approved in Scotland in March 2005; docetaxel (Taxotere) for types of lung cancer at £1,069.50 per cycle, approved in Scotland in May 2003; capecitabine (Xeloda) for gastric cancer at £585.48 per cycle, approved in Scotland in September 2007; and dasatinib (sprycel) for leukaemia at £2,606.63 per month, approved in Scotland in May 2007.

Two of the 21 drugs are not in the cancer field.  Both are for age related macular degeneration, which leads to blindness.  People in Scotland are able to access on the NHS ranibitzumab (Lucentis) and pegaptanib (Macugen).  The first costs £1,522.40 per cycle and the latter £514 per cycle.

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