Our intention should be to post all other electronic submissions there too. All responses will probably be eligible for publication in the paper journal. Responses really should be under 400 words and relate to articles published in the preceding month. They need to PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20019232 include things like 5 references, within the Vancouver style, including one particular towards the BMJ short article to which they relate. We welcome illustrations. Please provide every author’s current appointment and full address, and a phone or fax quantity or email address for the corresponding author. We ask authors to declare any competing interest. Please send a stamped addressed envelope should you would like to know no matter whether your letter has been accepted or rejected. Letters is going to be edited and may be shortened. www.bmj.com [email protected] sort of service our sufferers will acquire when this philosophy is taken to its logical conclusion and medical doctors are expected to pay for all of the therapies their sufferers have to have below the NHS conditions and terms of their service. That is the logical finish point in the lots of current primary care initiatives. It might be proper to restrict NHS funding for sildenafil (Viagra) as a life-style drug, but zanamivir appears to become a potentially lifesaving remedy that may benefit most of the UK’s population, particularly when the next influenza epidemic arrives. All members of our society supposedly have access to totally free NHS healthcare care, but this provision is now overtly rationed, and also a substantial quantity of treatments are merely not accessible owing to lack of funds. The moderately wealthy, like politicians, can afford healthcare insurance coverage with instant access to specialist care in sumptuous surroundings. NHS rationing, even so, applies towards the 1400W (Dihydrochloride) site productive majority of Middle England that are in operate but who don’t have, or can not afford, medical insurance or possibly a consultant’s private costs. These are the incredibly patients who could wish to spend their doctor a affordable charge for the a lot of procedures or drugs that the state is no longer ready to supply for them. They already subsidise the NHS, paying .90 per item in prescription charges, and they might want to purchase zanamivir directly from me if it only meant fewer extremely pricey days off operate owing to sickness. This is an option apparently denied to them.2 I’ve not abandoned the healthcare ethic. I believe a doctor’s duty would be to treat every single of their patients towards the very best of their potential, and so she or he can take no portion in rationing choices, which includes the management with the regional NHS primary care group. I also take into account the prohibition of powerful health-related treatment options to become morally as unacceptable because the Poor Laws of the nineteenth century. It echoes the ethics of an internment camp. It might even be illegal.P D Thomas general practitioner and dispensing doctor Gipping Valley Practice, Barham, Suffolk IP6 0AS Competing interest: None declared.1 Yamey G. Good to rule on influenza drug zanamivir. BMJ 1999:319;937. (9 October.) two Thomas PD. NHS Regulations deny patients low-priced drugs. BMJ 1993;306:1748-9.NHS regulations are of questionable legality Editor–As Yamey points out in his news report, the National Institute for Clinical Excellence considers that zanamivir (Relenza) will not be cost productive and so will incredibly closely monitor its use by physicians in NHS practice.1 In reality this can be a total ban, enforced by threat rather than by legislation. Because common practitioners are not permitted to provide any drug or treatment privately to their NHS individuals I wonderVery old peo.