New treatment policy: When Michael Gray was told he only had five months to live after being diagnosed with cancer, there was one faint hope that he could extend his life � a drug called cetuximab.

When Michael Gray was told he only had five months to live after being diagnosed with cancer, there was one faint hope that he could extend his life - a drug called cetuximab.

But it is not approved for use by NHS Grampian, so Mr Gray had to pay for it privately while he appealed to the health board to fund his treatment.

He also had to pay for chemotherapy, which he would have received free on the NHS if he had not opted to take cetuximab, and by the time he won his battle and NHS Grampian agreed to pay for his treatment, he had spent around £26,000.

Mr Gray and his wife Tina McGeever, from Buckie, submitted a public petition to the Scottish Government calling on ministers to "urge the government to consider the provision of cancer treatment drugs to ensure equity health across boards".

Mr Gray, 53, lost his battle with cancer in April, but his widow has vowed to continue his campaign and yesterday watched as MSPs debated the public petitions committee's report on the availability on the NHS of cancer drugs.

She welcomed the announcement by Health Minister Nicola Sturgeon that a review would be carried out into the guidance on co-payments -the system under a patient is treated privately while getting care on the NHS at the same time.

"The most important person is the patient and we have to look at how, from the very moment someone is told they are going to die, they are dealt with in terms of information and treatment," she said, adding that the existing guidelines were "unclear and confusing".

Ms McGeever wants cetuximab to be available on the NHS, but she also believes that a doctor should be allowed to prescribe a drug privately and offer other treatments on the NHS at the same time.

The British Medical Association, at its annual conference earlier this year, passed a motion which said precisely that.

But critics claim that this would create a two-tier NHS and breach the principle of equal access on the basis of need.

"Co-payments undermine the fundamental principle of the NHS," said Professor Allyson Pollock, head of the Centre for International Public Health Policy at the University of Edinburgh. "There are really no arguments in favour of them. If the drug is effective and worthwhile then it should be available on the NHS. Introducing co-payments would be privatising healthcare and creating a multi-tier system.

"There are several other issues. How does the patient know that the doctor prescribing the drug doesn't have a commercial conflict of interest? Is the patient going to pay when they buy these drugs and there are enormous side effects?

"The co-payment debate has no place in Scotland, not least when we have a government committed to extending free prescriptions to the whole of the population. Scrapping prescriptions on the one hand and introducing co-payments on the other is crazy."

A review of the rules has been announced south of the border. It has been reported that patients will be allowed to pay for some top-up drugs, but the results of the review, led by Professor Mike Richards, national cancer director, will not be published until later this month.

Andrew Powrie-Smith, director of the Association of the British Pharmaceutical Industry in Scotland, said that co-payments should only be allowed in "very exceptional circumstances".

"My main belief is that medicines should be available to all," he said. "We want to get the right medicine to the right patient at the right time and we want equality of access for all."

He added: "What we need to do is look at the system of how we assess the value of medicines to people and look at the way that we measure cost-effectiveness."

The Scottish Medicines Consortium, which approves the use of drugs north of the border, uses the quality-adjusted life-years measurement (QALY), which compares a new medicine with an existing one and calculates the overall benefit of the new drug.

Ms McGeevy, giving evidence to the public petitions committee earlier this year, said: "Michael succeeded in prolonging his life, albeit for a shorter time than we had hoped, but it was still longer than expected. For us, at a cost of about £26,000, was that additional time cost effective?

"For some organisations that look at quality-adjusted life years and statistics and at the population and not the patient, I cannot answer that question.

"For a human being such as Michael and all the other 400 people throughout Scotland who just want to extend their life, contribute to society and have a decent quality of life for longer, I would say that it absolutely cost-effective."

Jean Turner, chief executive of the Scotland Patients Association, said that cancer patients were being discriminated against and urged the review of the guidelines to go further to consider the actual policy surrounding co-payments. "If a drug is recommended by a clinician then I think the drug should be given," she said.

Ms McGeever hopes that the review will address some issues surrounding treatment for cancer patients. "We knew Mike was going to die. The reason he decided to take the fight to the parliament was so that everyone would have the same opportunity to access drugs on the NHS.

"We hope that at the end there will be some legacy that Mike will have left that will help other people."