31.03.14
NHS users should pay £10 monthly ‘membership fee’
Changes in the way the NHS are funded – including a potential £10 monthly ‘membership’charge – should be considered to avoid “starving” the rest of the public sector of resources, former health minister Lord Warner has warned.
The peer, who was minister for health reform in Tony Blair’s government, argues in a new report that tackling the “care crisis” requires the NHS to turn into a ‘National Health and Care Service’ (NHCS), based on a new partnership between state and citizen, with integrated health and social care available locally in the community.
The report, published by the free-market think tank Reform, proposes an NHS Membership scheme for all UK residents, including an annual health MOT to set new responsibilities each year for both the NHS and the individual.
Under the proposed NHCS, services would be refocused on early intervention in community for both managing chronic and mental health conditions and preventing illness. Many existing hospitals would then become hubs for integrated services closer to home.
There would also be stricter financial discipline such as a tougher efficiency programme raising £15-20bn to fund new Service Transition Fund (STF), allowing investment in new community health and care services. Efficiencies include converting under-used NHS estate to raise cash for STF.Other changes include means-testing people with complex needs for continued care and applying potential charges for hospital stays.
Lord Warner, and co-author of the report Jack O’Sullivan, added: “NHS efficiency could be improved significantly but, on its own, this will not close the looming funding gap. We have to be prepared to examine a wider range of funding streams than general taxation and to see if the NHS service boundary should be changed in relatively minor areas, without altering the fundamental principles of the NHS. We have had to tackle difficult challenges in other areas of public policy, such as pensions and welfare.”
However, a Department of Health (DH) spokesperson stated that the founding principles of the NHS make it free at point of use and the DH is clear that it will continue to be so.
“But we know that with an ageing population there's more pressure on the NHS, which is why we need to focus far more on health prevention out of hospitals,”the spokesperson said. “That's why we recently announced a named GP for everyone over 75, giving a more personalised service, and are bringing £3.8bn of health and social care funding together into a single seamless service to keep our elderly and most vulnerable well for longer.”
Additionally, a new ComRes poll, commissioned by The Whitehouse Consultancy, has revealed that more than half of Britons would not pay for a GP appointment, even if such a payment protected their local GP surgery from closure.
Despite charges existing for dentist appointments and prescriptions, the poll found that 56% of British adults oppose the idea of a £10 charge for a GP appointment, even if such a charge kept their local practice open. Approximately a quarter of the British public (27%) support the idea of a £10 charge, a figure that falls to just 15% if the cost of an appointment was £20.
Chris Whitehouse, chairman of The Whitehouse Consultancy, said:“The British public clearly feel the NHS should remain faithful to its founding principles of being free at the point of use. How any funding gap is addressed will be crucial to the future of the NHS, but the public has shown it does think it should be footing an additional bill.”
Although, the ComRespoll has revealed the public’s opinion, an NHS Confederation survey of MPs shows that nearly half of British politicians believe an NHS “free at the point of need” could be consigned to the history books if the challenges facing the health service are not addressed.
The survey of a cross-section of 100 MPs, conducted for the NHS Confederation by Dods, found that 48% of MPs fear a free NHS may be unsustainable in the future.
Rob Webster, chief executive of the NHS Confederation, says: “These results reveal there is cross-party consensus about the need to make changes to the NHS and that there are doubts about whether there is the political will to do so.”
The survey also reveals 81% of MPs believe the NHS in their constituency needs to change to meet the needs of patients in the future. Yet 65% say there is insufficient political will to permit change, and one in four say they would not back changes to their local NHS if their constituents are opposed.
“The resounding message from this survey is clear - we need an open and honest apolitical conversation between the public, patients, politicians and those delivering healthcare across our communities, about the future challenges facing the NHS,” said Webster. “We must then all support each other to drive forward the changes needed to ensure we can deliver a 21st century NHS where we have the right care, in the right place, at the right time.”
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