GP told to foot bill for Viagra

A FAMILY doctor who prescribed Viagra to a patient on the NHS has been told by his health authority to pay the full cost - or have it deducted from his pay.

Dr Peter Simmons, a GP at the Vine House Health Centre in Abbots Langley, Hertfordshire, has been told by West Hertfordshire health authority that the cost of two NHS prescriptions he wrote for a patient last October and November will be deducted from his pay.

The threat emerged the day after the British Medical Association defied the Government by urging GPs to prescribe the drug on the NHS to any patients who needed it. The BMA rejected proposed guidelines from Frank Dobson, the Secretary of State for Health, which would limit Viagra, on the NHS, to a small group of severely disabled men.

Dr Jonathan Reggler, a GP in Buckinghamshire, wrote an NHS prescription for a patient yesterday, complaining that the Government's proposed guidelines were "unworkable". He said thousands more GPs would be joining the Viagra rebellion, adding: "I think the BMA advice is spot-on and I am going to follow them rather than Frank Dobson."

However, the Government received backing from the Royal College of Physicians as a split emerged in the medical establishment's view.

Professor George Alberti, president, said rationing was inevitable in a cash-limited system and the guidelines reflected that. In a clear criticism of the BMA's stance, he said: "Those promoting Viagra for all should ask themselves what services should be withdrawn and which patients should not be treated in order to pay for it."

At least two GPs are known to have been threatened by West Hertfordshire health authority for prescribing Viagra on the NHS. Dr Simmons said he agreed to issue an NHS prescription after his patient paid for one pill privately and found that it worked. He said: "He had seen specialists and tried all the other treatments and although they worked at first they had ceased to be effective."

Dr Simmons issued two NHS prescriptions for four tablets each to the man between October and November last year. On Christmas Eve he received a letter from the health authority telling him that the cost of the drugs, plus the chemist's dispensing cost, would be deducted from his income - a total of about pounds 50.

"Not only was I within my rights to prescribe but, if there is a clinical need, I am obliged by my terms of service to do so," Dr Simmons said.

Viagra was licensed in the UK last September and the Government issued advice to GPs not to prescribe it on the NHS, other than in "exceptional circumstances," pending official guidelines which were published on Thursday. These propose that NHS prescriptions be restricted to a small group with severe disabilities, estimated at 15 per cent of all suffering from impotence.

Dr Simmons has sought legal advice from his defence body, the Medical Protection Society. He said the Government's "advice" did not amount to a ban, and in the absence of a ban the advice was overridden by his duty to prescribe to any patient with a clinical need.

"Viagra is cheaper than the other treatments for impotence and to prescribe it for this man seemed cost-effective and clinically reasonable. I discussed it with my partners and they agreed," said Dr Simmons.

Pfizer, the manufacturer, said West Hertfordshire was the only health authority it knew of to have issued such threats.