Right of Reply: Jonathan Reggler

A member of the British Medical Association's general practitioner committee responds to a leader on Viagra

A LEADER in The Independent of 23 January assumes that the British Medical Association (BMA) sees the conflict with the Government over Viagra as an issue of clinical freedom and uses this as an opportunity to do a bit of doctor bashing. It was particularly galling to be told that the BMA should be engaged in persuasive arguments "that National Health Service spending as a whole is too low". The BMA has been saying this for years and has published endless figures to prove it. Why successive governments have not found the arguments persuasive is a question that begs an answer.

The BMA's general practitioner committee (of which I am a member) rejected the guidelines of Frank Dobson, the Secretary of State for Health, and advised GPs to prescribe Viagra to those in need for two reasons. Firstly, NHS regulations ruling GPs' lives explicitly require us to prescribe those drugs that our patients need. Only certain drugs are banned, and Viagra is not yet one of them. Minor infringements of these regulations can lead to severe punishments, but Mr Dobson wants us to ignore the regulations when it suits him.

Secondly, whilst most GPs accept that rationing in the NHS is necessary, it should be fair and logical. Mr Dobson, had two ethically acceptable choices. Viagra for all of those in need or Viagra for no one. To give Viagra on the NHS only to those made impotent by a narrow range of causes and to deny it to all other impotent men is indeed, to use the words of the BMA, "cruel and unethical".