HEALTH watchdogs in Gwent want a UK-wide definition of what constitutes an episode of treatment in NHS cancer care.

Community health council members believe this should be a vital component of any solution to the thorny issue of whether patients who pay for their own drugs should also have to pay for the rest of their treatment, including blood tests and scans.

The issue of what are known as co-payments, or NHS top-ups, is currently being considered by Assembly health minister Edwina Hart.

But in England, public consultation has begun on proposals announced last week in the aftermath of a review by cancer tsar professor Mike Richards, which recommended that patients be allowed to 'top up' their treatment by paying for the drugs they want, but only under strictly regulated conditions.

Current rules state that people should be excluded from the NHS if they pay for treatment - such as drugs - that are not currently freely available.

This means they must pay for the likes of scans, blood tests, x-rays and other aspects of treatment, but some NHS trusts are more relaxed about the issue than others, leading to accusations of a postcode lottery.

The issue is contentious because there are fears that if top-ups are allowed, a two-tier NHS will be created, those who can afford it having access to drugs that others cannot.

The issue applies in theory to all treatments though cancer is often highlighted because many newer drugs are not yet licensed in the UK. A little over half (53 per cent) of 36 Gwent CHC members who voted on the issue in a consultation exercise for Velindre NHS Trust, Wales' main cancer treatment provider, were in favour of allowing top-ups for cancer drugs.

But they were almost unanimous in calling for a precise, UK-wide definition of an episode of treatment. Different interpretations among NHS trusts can lead to differing financial consequences for patients.

An Assembly spokesman said Ms Hart will take into account developments in England as part of her considerations of the issue.