Health services bosses have urged the government to stand firm on its proposal to restrict the NHS use of the impotence drug Viagra.

The intervention by the NHS Confederation follows mounting pressure on ministers to make Viagra more freely available on the NHS to men who suffer from impotence problems.

The Department of Health said it received about 800 submissions as part of its consultation on its proposals to restrict Viagra.

The consultation closed on Thursday and the department will now consider the submissions before producing final guidelines.

A spokeswoman said doctors, patients, patient groups and medical bodies had all contributed.

Many of these groups - including the British Medical Association - were critical of the interim guidance and made their evidence public.

Restrictions

On 21 January, Health Secretary Frank Dobson issued interim guidelines on the prescription of Viagra.

Under the guidance, Viagra is available on the NHS to men with conditions such as multiple sclerosis, diabetes and spinal injury.

However, he denied the treatment to men whose impotence was caused by psychological factors.

He then said there should be a consultation period and invited comments from all interested parties on how Viagra.

Viagra has caused particular interest because it is the first time a Health Secretary has intervened to ration NHS treatment.

The BMA's GP Committee said the government's guidance ignored clinical evidence.

The eligible categories of patients have been selected without regard to evidence of cost effectiveness, equity, or social values, it adds.

The King's Fund, an independent health care watchdog, also criticised the government's restrictions as unfair.

Stand firm

But Stephen Thornton, chief executive of the NHS Confederation, urged the government to stand firm.

He said: "We are dismayed that yet again, the BMA has rejected the government's approach without offering any sensible alternative course of action.

"On the one hand the BMA has said that decisions of this kind should be made by politicians.

"On the other hand they accuse Frank Dobson of not taking into account evidence of clinical effectiveness and public opinion."

Mr Thornton said the BMA could not have its cake and eat it.

"It appears that the BMA has given no thought to the cost implications of Viagra being more widely available.

"Which other patients in the NHS do they suggest should go without treatment to pay for it?"

Mr Thornton said that by setting limits on the NHS prescription of Viagra, the government was ensuring that the cost of Viagra can be met from within the existing expenditure on the problem of erectile disorders.

"Setting limits to health care is never easy but we believe these proposals are fair," he said.

"This will ensure we have a uniform approach around the country, avoiding the danger of 'post-code' prescribing.

"We would support similar action from the government in respect of new drugs in the future, as resources must be managed in the NHS so as to protect other more pressing priorities."