It seems to have slipped under the radar somewhat but when NHSreality looked carefully there were references and comment on the article in the BMJ 21st July 2015 by Ingrid Torjesen (BMJ 2015;351:h3971).: Government plans inquiry that could mean end of NHS free at point of use . No other country in the world tries to pull the wool over it’s voters as much as the UK, and no other country tries to be free and comprehensive and cradle to grave! The The Information Age means that citizens will not be content with covert rationing..
The Department of Health for England is considering an inquiry to look at how the NHS should be funded to ensure its future sustainability, which some doctors fear could put in jeopardy a founding principle of the NHS: that it is free at the point of use.
The inquiry was suggested during a House of Lords debate on the “sustainability of the National Health Service as a public service free at the point of need,” which took place on 9 July.
At the end of the debate the parliamentary undersecretary of state for NHS productivity, David Prior, said that he was interested in meeting Narendra Patel, who moved the Lords debate, and “two or three others” to discuss how an independent inquiry looking into the long term sustainability of the health service might be framed. He did not think that the inquiry would need to be a royal commission but that an organisation such as the health think tank the Nuffield Trust or the King’s Fund could be commissioned to examine the issues.
Commenting on the potential inquiry, Clive Peedell, co-founder and co-leader of the National Health Action Party, said that the proposal seemed to have “slipped by very quietly.”
He said, “Premiums, charges, and, potentially, insurance schemes are obviously completely against the ethos of the NHS, and the public deserves to be involved in the debate, if that is what they want to talk about.
“All the evidence suggests that we should be sticking with a tax funded system—progressive taxation. That’s the fairest way to fund healthcare. If you bring in charging and insurance systems, that just transfers risk from the wealthiest in society to the poorest in society in terms of bearing the burden of healthcare costs.”
In the House of Lords Patel pointed out that close to 9% of gross domestic product was spent on the NHS, that 89% of NHS trusts were forecasting deficits, that outcomes, including those relating to cancer and avoidable deaths, were poor, and that the NHS needed to achieve productivity gains far in excess of the 0.4% year on year that it had attained historically. “In this scenario the NHS will need an annual budget of nearly £200bn [€290bn; $310bn] by 2030 and one fifth of the nation’s entire wealth by 2060,” Patel said.
“The history of the past two and a half decades tells us that political parties will continue to manage the health service according to their ideology—managing scandals and giving a bit more money—but with no long term planning, as there will be no political consensus,” he said. “We need a national consensus that recognises and accepts that individuals, communities—including employers—and the state have a role in health and contributing to it.”
The former Labour health minister and peer Norman Warner backed an inquiry, saying, “Our tax funded, largely free at the point of clinical need NHS is rapidly approaching an existential moment. The voices of dissent and outrage will no doubt be deafening, but a wise government should begin now the process of helping the public engage in a discourse about future funding of the NHS. To do that requires a measure of cross party consensus on some form of authoritative independent inquiry that could produce analysis and a range of options for a way forward.”
The Conservative peer Patrick Cormack added that all forms of funding must be looked at. “We have to have a plurality of funding if we are to have a sustainable NHS. Whether the extra funding comes from compulsory insurances or certain charges matters not, but it has to come,” he said
Prior said that, having looked at many other funding systems around the world, he was “personally convinced” that a tax funded system was the right one. “However, if demand for healthcare outstrips growth in the economy for a prolonged period, of course that premise has to be questioned,” he said.
The health secretary for England, Jeremy Hunt, last week refused to guarantee that the current system of funding would remain. After a speech at the King’s Fund in which he set out a 25 year vision for the NHS,1 Hunt was asked whether the budget would continue to be funded by taxpayers for the next 25 years. He replied, “I am confident, but I don’t have a crystal ball.
”Iacobucci G. Hunt promises more transparency and fewer targets in “more human” NHS. BMJ2015;351:h3885.
Waiting lists are rising: Marie-Louise Conolly 22nd July 2015: Musgrave Park Hospital’s waiting list rises by 75%
The Budget is under duress: Hugh Pym 22nd July 2015: The health budget – under strain again and care of the elderly is impossible to fund (Nick Triggle 24th July 2015 – Is the cap on care costs doomed?)