Author Topic: Government proposes inquiry into moving to a 'pay NHS'  (Read 4305 times)

NeuralgicNeurotic

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https://opendemocracy.net/ournhs/richard-grimes/government-moves-to-consider-nhs-user-charges

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Last week the government quietly announced a review into the biggest political hot potato of all - and almost no-one noticed.

Imagine for a moment that you are the newly re-elected Conservative Prime Minister, and you want to launch an inquiry into whether the NHS should be paid for in future through user charges and insurance, not through tax.

But you’ve got a problem - you’ve just won an election without breathing a word that you were considering such a fundamental change to the funding of the NHS.

So how would you make such an announcement?

Very quietly, of course.

Last week the government did just that.

If David Cameron, or his Chancellor or Health Secretary had announced such an inquiry to re-consider a principle that has been sacrosanct since 1946, you’d expect front page headlines and Newsnight specials considering the implications. You’d expect a bit of a flurry (to say the least) about whether Cameron was back-tracking from his promises about what voters said was their number one issue.

But the launch of this inquiry has not been reported in the mainstream media, at all.

Why? Because it was casually announced by a little known minister, the newly ennobled “Under Secretary of State for NHS Productivity", Lord David Prior, in the rarefied atmosphere of a House of Lords debate on the “sustainability” of the NHS, moved on 9th July by crossbench peer Lord Patel.

The principle of how the NHS is funded has (mostly) stood firm since 1946, summed up in clause 4 of its White Paper:

“All the service, or any part of it, is to be available to everyone in England and Wales. The Bill imposes no limitations on availability – e.g. limitations based on financial means, age, sex, employment or vocation, area of residence, or insurance qualification.”

That is, the NHS is available to everyone, whether or not they can afford to pay user charges, or whether they are insurable. The question about whether the NHS could be funded through user charges or insurance is answered here: No it shouldn't.

But where better to have the sort of debate that no one has voted for, and launch an inquiry that no-one has voted for, than in the House of Lords, which no one has voted for?



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Prior – recently elevated to the Lords from his stint as the strongly pro-market chair of the Care Quality Commission, formerly a Conservative MP and deputy party Chair – led for the government in the Lords debate.

Before he seized the opportunity to push his agenda, he said he listened to the “strength of feeling” in the unelected House.

Tory peers like Lord Cormack argued in favour of moving away from tax funding, saying:

"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.”

Matters not!? As a true Tory, he says that the funding should not come from taxing the rich (which he does not even countenance), but instead from taxing the sick.

More disappointing were the contributions from Labour peers like (the notoriously pro-privatisation) Lord Warner:

“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."

Far from endorsing the tax-funded system that is widely acknowledged to be the fairest way of paying for healthcare, here we have Labour peers suggesting the government should "help" the public to think of other ways to pay for healthcare.

Another Labour peer, Lord Desai, suggested bizarrely that patients should be issued with an "Oyster card" which is deducted whenever a patient uses healthcare, and patients should receive a "bill" at the end of the year, saying this would “help make it clear to people that a free National Health Service is not a costless one."

Shades of Jeremy Hunt's daft suggestion to put the price on prescription medicines.

But the problem with the NHS is not unnecessary demands, it is the sheer magnitude of people who need healthcare. An "NHS Oyster card" will not reduce the number of elderly people with acute co-morbidities. And if "consumer demand" is a problem, the solution is to turn patients back into patients rather than healthcare consumers, and remove the market.



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Once their Lordships had had their say, Prior concluded for the government, saying that though he “personally” liked a tax-funded system,

“if demand for healthcare outstrips growth in the economy for a prolonged period, of course that premise has to be questioned."

And he announced the ‘way forward’:

"I would like to meet the noble Lord, Lord Patel, and maybe two or three others, to discuss this in more detail to see whether we can frame some kind of independent inquiry—I do not think that it needs to be a royal commission. We are not short of people who could look at this issue for us; there are health foundations, such as the Nuffield Trust and the King’s Fund.”

Prior ignores the fact that the Kings Fund has already recently carried out an inquiry, the Barker Review, which rejected user charges and called instead for more taxes to pay for healthcare, in particular through a review of inheritance tax and national insurance increases.

Both of which George Osborne has just cut, of course.

So Prior orders another inquiry, this time using people he has chosen and presumably people who will produce the desired result. Such a fundamental inquiry should involve the public and be held in public, but it appears Prior does not want the public involved.

Is Prior, in announcing an inquiry into so fundamental an issue, acting above his paygrade as an unelected junior health minister?

And are we being nudged towards an inefficient, unfair ‘pay NHS’ in the only way possible – undemocratically?

lankou

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #1 on: 17 Jul 2015 10:42AM »
The dark hand of Unum working Tory puppets.

Hurtyback

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #2 on: 17 Jul 2015 12:47PM »
They are going to keep commissioning enquiries until one comes up with the opinion that suits them  >angry<

SteveX

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #3 on: 17 Jul 2015 01:50PM »
They are going to keep commissioning enquiries until one comes up with the opinion that suits them  >angry<

Isn't that how they do everything? 
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Otter

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #4 on: 23 Jul 2015 06:12PM »
 >angry< here we go again

Offworld

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #5 on: 23 Jul 2015 09:17PM »
 >rolling-eyes<

They want to turn Britain into a copy of the USA -- but without including any of the arguably better aspects of that.

Sunny Clouds

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #6 on: 25 Jul 2015 01:00AM »
True story.

Close relative of mine, I never met (as you'll soon see why).

A little bit older than my parents.

Had diabetes.

After insulin was discovered and commercially marketed and available.

Before the NHS.

He died.

Another relative developed diabetes after launch of NHS.

She lived to a ripe old age.
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Sunny Clouds

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #7 on: 25 Jul 2015 01:04AM »
More food for thought about affording treatment.

Over the years, I've tried to keep up with research into bipolar disorder, and you won't be surprised to know that research into lifespan interests me.

A couple of years back, I found some proper peer-reviewed research showing bipolar disorder shortens your life expectancy by 25 years.

I was shocked - until then, all the research I'd read said it shortened life expectancy by about 10 years.

I looked at the research again - yes, almost all said 10 years.

So why did one say 25 years?  An extra 15 years knocked off the lifespan in that piece of research?

American research.

Yes, privatised healthcare with an inadequate safety net kills.

40 million people in America have no Medicare, no Medicaid, no health insurance.   

We kid ourselves if we think it doesn't impact on people's life expectancy.
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

auntieCtheM

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #8 on: 25 Jul 2015 01:05AM »
38 Degrees are having a campaign about this at the moment.

Sunny Clouds

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #9 on: 25 Jul 2015 01:10AM »
Dementia - why do they want to diagnose?

The government supposedly signed up to international agreements for timely diagnosis, then pushed for early diagnosis.

Dementia is the only diagnosis, to the best of my knowledge, where the government decided to pay a reward (£55) to GPs to diagnose it.  Not to refer for tests or diagnosis.  To diagnose it.

Why?

I don't know, but if you were a health insurer, would you want to insure anyone with a dementia diagnosis?

Ok, I'm cynical, but given the entanglement of the last three governments with health insurers and the high proportion of MPs and peers with an interest in private health companies, I think I'm entitled to be.

After all, they're not offering a bonus to diagnose more insurable conditions, are they?

Sorry to be bleak, but is there anyone here who seriously thinks this government isn't going to either destroy the NHS or come very close to it?

 
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Sunny Clouds

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #10 on: 25 Jul 2015 01:13AM »
I'm trying to break my posts up into different sub-topics.

One thing that makes me angry is hospital buildings.

What am I on about?

Well, once upon a time, there was expletive-all healthcare for the poor, but hospitals were built in many places.  People chipped in together in mutual funds and rich benefactors helped.

Then the NHS was created and took over the hospitals.

If the NHS is dismantled, sure as hell those hospital buildings won't be given back to the poor who chipped all their money in together and got money from benefactors as well to build them.

(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Hurtyback

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #11 on: 27 Jul 2015 07:30PM »
That's a good point Sunny. It's not just historical either. I'm sure many of us will remember campaigns to raise money to equip local hospitals. I certainly remember sophisticated scanners and neonatal ICU equipment being purchased for local hospitals with money from public campaigns.

ditchdwellers

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Re: Government proposes inquiry into moving to a 'pay NHS'
« Reply #12 on: 29 Jul 2015 12:33PM »
Very true Hurty. The 'Friends' group at my local hospital paid for the changing facilities in the hydro pool to be refurbished.  Without the extra funds raised and the support of the local community,  many hospitals would be much worse off and the patient experience would be diminished.