Responding to the publication of Professor Mike Richard's review 'Improving access to medicines for NHS patients', The King's Fund chief executive Niall Dickson said:

'This is a landmark report. The decision not to withdraw NHS care from patients who choose to purchase additional drugs is a welcome one. Continuing with the status quo risked real damage to the reputation of the NHS as a caring and compassionate service.

'The government is also right to rule that patients opting for an extra drug should be billed for any costs associated with giving them that drug. Patients with the means to purchase extra care should not be punished, but nor should their decision lead to extra costs for their local health service.

'Plans to encourage primary care trusts to work together when deciding whether a patient's case counts as exceptional are overdue and sensible. Some cases involve rare conditions that individual trusts will encounter infrequently. Bringing expertise together should mean better decisions while allowing local services to manage their own priorities.'

'However, it is not clear whether the Department of Health believes the principle of keeping NHS and private elements of care completely separate can or should be extended beyond drugs to devices and other therapies. Some clarity around this would be helpful.'

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