W HENR Frank Dobson was hard-hitting opposition spokesman during the 1980s, before New Labour had been invented, he was the leading MP in an active campaign against private medicine under the excellent title "NHS Unlimited".
Since then it has been downhill all the way. Now, a decade later, it has fallen to Frank Dobson as Health Secretary to take new steps to limit the scope of the health service.
In mid January he finally responded to the development of the anti-impotence drug Viagra by spelling out the first formal proposals for rationing and restricting its availability to a small percentage of those who need it.
To make matters even worse, Dobbo, the former scourge of the Tory "two-tier" system, now suggests that GPs could use make use of Tory legislation from 1992 to write private prescriptions for the drug for impotence sufferers who do not qualify for NHS prescriptions but are wealthy enough to fork out f6 per tablet.
Angry GPs point out that as few as 15% of impotent men would meet Dobson's strict five-point criteria and qualify for Viagra on the NHS. And they complain that it is arbitrary and irrational - and even unethical - to treat the same health problem differently according to the factors that caused it, effectively creating a "two tier" system of impotence INT DOTLOOK THERE'S A HUGE WAITING LIST TO HAVE A GO AT DOBSON.
WARD sufferers, and distinguishing between "good" and "bad" reasons for erectile dysfunction.
Depression
Estimates vary on how many men suffer from impotence - a problem which has been understandably under-reported, but which can lead to severe mental distress, clinical depression and CVel suicide, and which can imperil relationships. Only minority are expected to come forward and seek the drug.
Many sufferers are elderly, but only the wealthiest pensioners will dee able to afford private prescriptions of a drug which could significantly improve their quality of life.
The New Frank Dobson was scathing in his attempts to downplay the misery of impotence and justify his tight-fisted attempts to ration NHS spending: "Impotence is in itself neither lifethreatening nor doers it cause physical pain," he said. Maybe. But this is not a formula for health but a recipe for a long and miserable life. Since medical science has produced a new, safe and effective cure for a debilitating condition, and can now improve the lives of large numbers of mainly older men -and their partners - the question has to be why this particular drug has been singled out as the first to be explicitly and deliberately rationed.
It appears that Dobson - who remains (to his credit) one of the few public atheists in a prudish and Bible-bashing Blair cabinet -has been swayed by the "moral" outrage of the right wing press hinting that NHS prescribing of. Viagra would unleash Frank Dobson orgies of randy pensioners and used to support the its widespread "NHS Unlimited" use as a recre- campaign against ational drug at private medicine: now the taxpayers' The is the man limiting expense.
If Viagra was a access to new wonder drug to treatment tackle "mainstream" medical problems such as heart disease or diabetes, this type of debate would never have occurred.
This is also why Dobson, and Blair himself, who swiftly endorsed the rationing plan, have chosen wildly to exaggerate the likely numbers who would seek Viagra, and its potential cost to the NHS. Blair claimed that "To spend hundreds of millions of pounds on prescribing Viagra on the NHS would not be a sensible use of resources." But Pfizer, which manufactures the drug, has already seen demand elsewhere peak and BE POBLIC HEATH decline, and projects that no more than 50,000 men would seek prescriptions in Britain in the first year, with steady growth to around 200,000 over five years.
No extra The initial cost of £12m a year would, on these estimates, be little more than current NHS spending on less effective treatment for impotence.
The danger is that after exploiting the phony "moral" confusion around Viagra to push through the principle of rationing certain types of care, and cynically playing off one type of medical problem against others.like cancer and heart disease New Dobbo and his co-thinkers will now spread the net to restrict the availability of other comparatively expensive drugs and forms of treatment, treating minority medical problems (such as Beta Interferon for multiple sclerosis or cochlear implants for the deaf), which in some cases have the potential to destabilise the budgets of under-funded health serVIces. Of course there are other ways of tackling the costs of innovatory medical treatment. Dobson could have used the monopoly purchasing power of the NHS and mounted a concerted effort to force Pfizer to drop the price per tablet of Viagra. New Labour could implement the long-standing call by socialMany luckier. can you, sir? 4444 ists for the nationalisation of the drug companies or even - in the case of multi-nationals - look towards a substantial turnover tax on their operations in this country.
In a more radical move, Gordon Brown could simply scrap the ludicrous top limit on National Insurance contributions, which benefits only those at the top of the salary scale, and gain an extra £3.5 billion to pump in to health and other public services, eliminating the problem at a stroke.
Exploiting the problems of an NHS which lacks the funds, staff or front-line beds needed to deal with peaks of demand for emergency and elective treatment, the vultures of the far right are again circling as they did in the Thatcher years, advocating their well-worn line of private medical insurance and more charging for NHS treatment.
The Sunday Times recently editorialised on the headline-grabbing flu crisis by advocating hefty charges to visit a GP, and arguing that New Labour should herd more people down the road to join the minority (one in eight) who are covered by private health plans.
This is similar to the the line being peddled by Ann Widdecombe, one of the few recognisable Tory shadow ministers.
With today's spineless and silent trade union leadership, a barely detectable left in the Labour Party, and New Dobbo advocating private prescriptions, we must wonder who will have the nerve to hold the line for a properly state-funded, compreLOM HAY