Viagra: on release

Let the sunlight in, let the people speak

Editorial p 759 News p 765 Medicine and the media p 824

The inability of Britain's government to come to terms with rationing is exposed by this week's “interim guidance” that doctors should not prescribe sildenafil (Viagra) (pp 000, 000).12 The government should use this opportunity to lead the debate that Britain needs on what will be provided on the NHS, who will decide, and how.

The fiction of the NHS, encouraged by this government and the last, is that the NHS can provide a comprehensive, high quality service that is free at the point of delivery and covers everybody. The reality, well recognised by most of those working in the service, is that health systems cannot meet all four principles.3 Something has to …