Is a fee the only way to save the NHS?
The Organisation for Economic Cooperation and Development has said that 23.8% of the UK’s GDP is spent on Welfare this is not just things traditionally seen as welfare but also pensions and “other social spending” this is the same as in 2010. This shows that the Coalition is struggling to get to grips with spending and the report goes onto warn that with the UK’s rapidly ageing population, if spending is not bought under control then our NHS and pension system face the risk of collapsing.
Changes have already been made to pensions to try to remove some of the pressure on the system however, despite recent NHS reforms it is highly likely further more drastic reforms will be needed to save the health service. One proposal I have heard is to pay a fee to see a doctor, this system is used in France and it has many advantages over our own system. Firstly a fee dispels the myth that the NHS is free, the NHS is not a free service everything has to be paid for however the service is used like it is free. This means people miss appointments and people see their doctor for small things like colds which don’t need a doctor, all this puts pressure on an already strained system. Secondly a fee would help to fund the NHS the government could keep funding consistent and the fee could be used as additional funding which could help increase staff numbers and improve facilities. Thirdly, it would kill the idea of health tourism because people would have to pay to use the health service.
Admittedly the advantages of a fee are few and the disadvantages are many, one big question is what exactly would the fee be. On this morning’s Wright Stuff a fee of £25 was debated I think this is arguably to much particularly for low paid workers, those out of work and young families. I think there are several ways around the problem of people not being able to pay, you could exempt certain groups from paying so pensioners, children and those earning minimum wage or below would be exempt however this is not a fool proof solution. As seen with the Winter fuel allowance and other pensioner benefits some pensioners are well off and could afford to pay the fee, the same thing applies for children as many parents could afford to pay a small fee. This would mean the system would be full of waste as many of those avoiding paying the fee could pay it. Another way of making the fee fair would be a sliding scale based on your tax bracket, so those how earn the least would pay a much smaller fee than those who earn the most and those children could get free health care. Another problem with implementing a health care fee would be deciding how to fee would be applied, would you pay it for just seeing the GP, would you pay it per treatment or would you pay it upon using the health service. It is likely the fee would be paid based on using the health service no matter what you used it for but this has its own problems, for example if you are in a car crash and require emergency care you may be given the care without your consent, should you then pay for your care? The biggest problem with a health care fee would be how politically unpopular it would be, only a government which was certain of not being re-election would even attempt to implement such a policy and it would be extremely difficult to whip back bench MP's into voting for it.
To conclude I don’t think a fee would be the best way of funding the NHS in the future mainly because it would be highly complex and I believe there are much better ways of funding the NHS such as a separate health service tax. Also once the Coalitions health care reforms affects can be seen maybe the NHS will not require any more reforming to make it affordable in the future. I have attached a link that briefly details how other European nations run their health services each of these methods is also an alternative method we could implement to make our own NHS more sustainable. http://www.guardian.co.uk/healthcare-network/2011/may/11/european-healthcare-services-belgium-france-germany-sweden