The Methodist Church has called for a wider debate about the principles and values of a universal health system after the Government announced it would allow patients to buy extra medical treatment not available on the NHS.

The Methodist Church urged the Government to clarify its proposals, saying that they raised new questions about equality and fairness.

Paul Morrison, Public Issues Policy Adviser for the Methodist Church, warned that the plans had the potential to develop into a two-tier healthcare system that disadvantages the poor.

"I am concerned that without Government commitment and vigilance we will wake up some day in the future in a country with a first class health care system for those who can afford it and an economy class system for those who can't," he said.

"This decision may lead to challenging ethical questions within our churches and wider communities. Drugs such as donepezil are not available to NHS patients with early stage Alzheimer's disease.

"How do we react to two people sitting on the pew next to each other both wanting this treatment, but only one is able to afford it? This raises huge ethical questions for individuals, church communities and society as a whole."