The Price of NHS Care: £10 A Month?

31 March 2014

The Price of NHS Care: £10 A Month?

Former health minister Lord Warner argues that a monthly fee of £10 could be collected alongside council tax to combat current declines in NHS care; this ‘membership charge’ has already provoked outrage from members of the public who argue the NHS system is sufficiently subsidised by National Insurance contributions while the other side of the coin maintains this is a relatively small amount to safeguard patient care outcomes. Which side of the fence are you on?

Mistreatment.com has heard from members of the public about their concerns regarding high rates of avoidable and expensive hospital admissions, medical mistreatment as well as poor care of elderly people, for example. However, is a monthly fee the best way to alleviate these concerns, tackle a spending gap and deal with medical mistreatment?

Lord Warner served under Tony Blair, and the former Labour health minister feels the £10 a month fee is the only way to offset declining NHS standards and help pump in further funds into an overall system which is already unsustainable and, in his opinion, cannot hope to progress in the future without a significant amount of further cash injections.

Originally writing in The Guardian newspaper Warner stated that "Many politicians and clinicians are scared to tell people that our much-beloved 65-year-old NHS no longer meets the country's needs"

"The NHS is often poor value for money"

"Frankly, it is often poor value for money. The NHS now represents the greatest public spending challenge after the general election. MPs taking to the streets to preserve clinically unsustainable hospital services only damage their constituents."

His opinions come in the wake of a joint produced report created for a thinktank called Reform and which argues that the NHS will face a gulf between patient demand and healthcare supply to the tune of £30bn by 2020; he further argues that this gap means that while there will be significant patient care demands which simply cannot be met by the NHS whose ability to respond will be impacted directly by the lack of funding streams needed to sustain it. Warner argues the membership fee goes some way towards tackling this inevitable problem.

Is the membership fee a form of poll tax?

Due to the fact that individuals will be living longer, with a greater variety of supplemental healthcare in the form of pharmaceuticals alleviating pain conditions as well as rising obesity, for example, Warner feels that incidences of ill-health will not only be heightened but prolonged due to the current capabilities available to ‘manage’ worsening health. In the eyes of Warner, therefore, visitors staying overnight in hospital should be more or less be paying ‘hotel charges’.

Together with the thinktank, Warner argues this monthly fee can also fund initiatives to prevent ill-health, funding health examinations on an annual basis for working persons.

Unsurprisingly the proposal has led to criticism from both the medical profession and the public with most views stating that the membership fee severely compromised the widespread and inherent belief that the NHS was free at the point of access

Dr Clive Peedell, an NHS oncologist who is co-leader of the National Health Action party, said the monthly charge was dangerous as it was being spread across the board as a ‘flat tax’ which meant both rich and poor users of the NHS would be paying the same amount. His solution to find the extra money needed to ‘sustain’ the NHS would be better extracted through those avoiding tax and using that siphoned off money to improve healthcare instead.

"The NHS needs to be, and should be, free at the point of use"

"Any attempts to introduce what would amount to an NHS tax on patients puts us on the slippery slope towards the end of an NHS that needs to be, and should be, free at the point of use," said Dr Ian Wilson, chairman of the British Medical Association's national representative body.

"The BMA remains strongly opposed to any attempts to introduce charging patients, whether that is a monthly payment, for hospital admissions or for GP appointments."

Warner further continued to argue in his article that harsh financial conditions and ongoing austerity plans would only worsen and be prolonged, whichever party takes hold of the country in the next election, and that tax by itself would not be the solution to aid the NHS. Rather, extra funding needed to come from other pockets-the users of the NHS themselves.

"Over-protecting an outdated, cosseted and unaffordable healthcare system inevitably means starving other vital public services, unless we choke off economic growth and worsen the cost of living with big tax increases” he argued further adding

"That might all be worth contemplating if the NHS was offering brilliant care. But it isn't"

The Department of Health was clear in its condemnation of the idea, arguing "The founding principles of the NHS make it universally free at point of use and we are clear that it will continue to be so. This government doesn't support the introduction of membership fees or anything like them..but we know that with an ageing population there's more pressure on the NHS, which is why we need changes to services that focus far more on health prevention out of hospitals."

Mistreatment.com frequently deals with a range of members of the public right across the spectrum of society. A £10 fee per month may well be out of reach financially for some people-what would happen in their case if the fee was introduced? Another argument would simply be that NI was introduced purely for this end, so why introduce a new fee especially since the thought behind NI at its inception was to be a contribution to all the social "benefits" society receives from the state-including the NHS?

To tax or not to tax?

Another worrying development might be that £10 is a purely arbitrary figure. If the gulf of unsustainability is so significant, as Warner describes it, then if this recommendation becomes binding law-there would be nothing to stop this ‘membership fee’ rising to £20 a month and then £30 and even more, and what if wages do not rise with inflation to offset the increase in the monthly fee?

Additionally, how sustainable is Warners’ own argument that existing taxation-or further methods to increase the scope of taxation from the wealthy-is not enough to support the NHS properly? Why is a special fee required in that case when the public has seen companies like Amazon and Starbucks escape taxes?

Privatisation or not?

There is also a rising swell of public opinion that the comments Warner has made only exacerbate the argument in some circles that the NHS is rife for privatisation with its ‘unsustainability’ only capable of being tackled with properly by private companies. The question remains then can Warner really be providing an unbiased opinion? Especially as a paid adviser to General Healthcare Group, which in turns owns BMI Healthcare, the UKs largest private hospital group, running approximately 70 hospitals nationwide?

There’s a lot to think about here and we want to hear from you-encourage debate on our Facebook page, Google Plus page and of course on Twitter, use the hashtag #nhsfee and let us know what YOU think.

We want to hear your views

Mistreatment.com has a number of specialist departments which deal with enquiries relating to a variety of medical health complaints and medical related negligence areas. Mistreatment.com was created to listen to talk to people who feel that they had nobody at the NHS to listen to them when something went wrong. Members of the public who call through to us often want to raise an issue within NHS care so that somebody else is not affected the way their and their loved ones have been. Sometimes they call through to us to make a medical negligence claim because a financial settlement is needed to rebuild their life and to take care of their family. If you have experienced a form of medical mistreatment through emergency services, A&E or through surgery, for example, you can speak to the experts at Mistreatment.com