Cancer survivors have hailed proposals to bring back prescription charges to finance a dedicated specialist drugs fund for Northern Ireland patients.
The charity Cancer Focus, which has lobbied for access to expensive drugs that are available in Britain but are difficult to obtain here, described the launch of a 12-week consultation into the reintroduction of charges by Health Minister Jim Wells as "a great step".
The move comes after a review was carried out into the current process for accessing specialist unapproved cancer drugs - a system previously criticised as unfair.
Mr Wells said the revenue from reintroducing prescriptions charges, which were scrapped in 2010, would generate much-needed cash to obtain expensive medication. The Department of Health hopes to raise £5m-£10m from the fees.
The money generated would pay for drugs that are either too costly or too specific to be licensed by NICE (National Institute for Health and Care Excellence) for general use.
Mr Wells said: "I repeat my belief that patients should have access to the drugs they need and I want to put funding for this on a secure financial footing. I cannot do this without finding a source of additional income."
He added: "In view of the current financial position, and the need to invest in services, such as the provision of new specialist drugs, I believe that this may be an appropriate time to reconsider the provision of free prescriptions in Northern Ireland."
However, some politicians and cancer patients believe the money for specialist drugs should come from the existing budget and not funded by prescription charges.
Calls for more clarification over how the process and administration costs would work were also made by Alliance and the SDLP.
There are around 40 cancer drugs unavailable in Northern Ireland. Currently the only way a patient can access them is if a clinician puts through an Individual Funding Request (IFR). However, this system has been labelled unfair as it requires a patient's case to be exceptional or rare. Among the four key recommendations of the review into cancer drugs provision was a proposal to ease IFR restrictions which would allow more people to receive the drugs.
Roisin Foster, Cancer Focus NI Chief Executive, called the recommendations "a great step in the campaign towards securing equal access for patients here".
And Margaret Carr, of Cancer Research UK, added: "There are difficult choices to be made about how this is best funded and we hope the public will engage in the consultation."
But former Health Minister Michael McGimpsey, who scrapped the charges five years ago, criticised the move.
"We don't charge for a GP, we don't charge for a hospital bed and we should not be charging for prescriptions. Those people should have been getting the drugs they needed a long time ago without going through all this."The three payment options on the table
1. Reintroduce charges: The first of the three options being considered is to bring back the same system of prescription payments that was in place across Northern Ireland until all charges were abolished by Health Minister Michael McGimpsey in 2010. Reintroducing a charge of £3 for each item at the pharmacy would generate income of around £5m per year, although some groups of people would be exempt from paying the fee.
2. Increase exemptions: The second option on the table would be to adopt a similar system to that which was previously in place, but increase the number of possibilities for patients to be exempt from paying the charges. For example, one possibility would be to adopt the practice which is currently in place in England, where all patients receiving treatment for cancer get their prescriptions filled free of charge.
3. Universal charge: The final option is to introduce a universal charge for prescriptions that everyone would pay. The exact process has not been disclosed, but one suggestion is for a season ticket-type system, where all patients pay an annual subscription of between £20 and £25. This system would result in a much lower rate of, say, 50p for each item, but with no exemptions at all.