The former Labour health minister Lord Warner, who has ‘formed an unholy alliance with the rightwing thinktank Reform’. Photograph: Don Mcphee
Simon Stevens, until not too long ago a vice-president of the US wellness giant United Wellness – and ersthwhile Blairite well being adviser to New Labour – took in excess of this week as the NHS chief executive. It can hardly have been by opportunity that his arrival coincided with two new reports recommending the introduction of up-front costs for NHS care –one from the King’s Fund, the other from an unholy alliance amongst the former Labour wellness minister Lord Warner and the rightwing thinktank Reform.
Both reviews start from the unchallenged but erroneous assertion that the NHS is “unsustainable”, and are padded out with a plethora of platitudes about a lot more care in the community and the merging of wellness and social care solutions. But at their heart are radical recommendations for the introduction of upfront charges for the NHS. In the case of Reform, this would be a “recommended” £10 “membership charge” a month.
Research is clear that expenses of this type deter the poor and the elderly – the quite men and women who need the NHS most – and as a end result they present later with far more advanced sickness. To Warner and the pundits at Reform £120 a year could not look considerably, but it will feel like the last straw to these already struggling with the consequences of austerity. The public understand this and, as a current survey displays, are overwhelmingly towards upfront payments.
There is no monetary, ethical or clinical argument in favour of upfront expenses for the NHS. The most efficient and the fairest way of funding it is by means of progressive central taxation. Flat-price charges, this kind of as these proposed, would require to be indicates-tested, a reality that Warner was forced to concede in a radio interview. He also admitted that the costs as laid out would only increase £2bn a year, a drop in the ocean of the NHS funding gap.
This raises the query of the level of introducing a technique of means-examined costs that would practically definitely raise much less money than it would price to administer. But there is no secret about the agenda here. Reform is funded by the very folks who would benefit from undermining the fundamental concepts of the NHS. The listing of their donors contains major insurance companies, management consultants and private healthcare companies.
Reform is essentially a third celebration speaking for people whose voice – for very good cause – is not trusted it is a front for the well being industrial complicated, which for many years has worked to get its hands on the NHS spending budget. They recognize that once the fundamental concepts of the NHS are breached with upfront payments, it will be a quick phase to best-ups, co-payments and insurance coverage to cover the escalating fees. Consequently their enthusiasm for the big conversation about the “unsustainablity” of the NHS and their remedy of conserving it with modest direct charges. Who could possibly be churlish enough to say no?
It is no surprise that neither report mentions far better approaches of raising or conserving money for the NHS: £10bn a year could be saved by ending the market place in the English NHS, a lot of a lot more by tackling the PFI debts emptying taxpayers’ funds into share holders’ pockets – £11bn of infrastructure is costing us in excess of £60bn to fund. But these solutions would not benefit the backers of Reform.
No politician with any sense would publicly endorse these proposals for costs, but however they have served their function: they have reinforced the myth that the NHS is “outdated and unaffordable”, and re-animated the zombie policy that it could be saved by upfront personal payments. With phone-in hosts striving to persuade callers that it would be completely affordable to spend less than the cost of a tin of salmon each week to conserve the NHS, Reform’s corporate backers have to take into account their income to have been well invested.
The rest of us will view this as a poll tax for the NHS and act accordingly. Simon Stevens, as he will take over the reins of the NHS, ought to not underestimate the strength of public feeling against undermining one particular of the founding concepts of the NHS.