The UK government last week issued draft guidance to doctors on when they could prescribe sildenafil citrate (Viagra) to patients on the NHS. Doctors' representatives immediately rejected the government's proposals as “cruel and unethical.”

Frank Dobson, secretary of state for health, said that GPs could prescribe Viagra and other drug treatments for impotence only to patients who have undergone prostatectomy or radical pelvic surgery, or have a spinal cord injury, diabetes, multiple sclerosis, or single gene neurological disease.

The minister says that NHS treatment may also be available “in a hospital setting subject to specialist assessment in those exceptional circumstances where impotence is causing severe distress.” Doctors will be advised to restrict their prescribing of treatment for impotence to one treatment a week. Patients not suffering from one of the named conditions would be able to get a private prescription. The pills cost about £6 each.

Mr Dobson pointed out that if Viagra were freely available the cost of treating impotence could increase 10-fold or more. He said that he wanted to keep spending …