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The National Health Service in England is calling an end to the controversial policy of charging patients for all their care when they choose to top up their treatment by paying for drugs that are not available on the NHS.

A review of the same policy here in Wales will report in the New Year, raising the hope that patients might benefit from a similar directive from Cardiff Bay. But many remain to be convinced that allowing top-ups would be a step in the right direction.

The concern is that making it easier for patients to top up their care could open the door to a two-tier NHS where the treatment patients receive depends on their ability to pay.

Dave Galligan is head of health for the public sector union UNISON in Wales.

"The NHS has always made hard choices on access to some treatments. The problem is, we're going to have hard choices - or we have hard cash. The reality is that we will end up with people making easy choices - as long as they can afford to."

Mr Galligan hopes that the NHS in Wales can chart a different course from that in England.

But Jonathan Morgan - the Conservative's health spokesman in the National Assembly - offers a differing, second opinion.

"This idea that someone living in Monmouthshire would have to continue paying for their care where someone living in Hereford next door actually gets top-up payments - that would be inconceivable. Something of this magnitude should be done on an England and Wales basis."

Which prescription will do the trick? Eye on Wales investigates.