The NHS is rarely far away from a crisis. Even so, the last few months have been particularly tough. The junior doctors’ strikes have grabbed the headlines, but perhaps even more worrying for the future of the NHS is the state of its finances. Trusts are falling deeper into debt, yet the biggest budget squeeze is still a year away. It may be time, then, to rethink the way the health service is funded.
The subject was tackled by a panel of eminent doctors and journalists at a recent Spectator lunch. The question was: ‘Can the NHS afford the healthcare we want?’ a strong consensus held the answer was no and that the NHS needed more money to cope with dramatically rising demand. That was the easy bit. The harder question was how the money should be raised.
The attendees were Professor David Haslam, chair of NICE, Professor Jane Dacre, president of the Royal College of Physicians, Dr John Giles, medical director at Benenden Hospital Trust, Fraser Nelson, editor of The Spectator, Hugh Pym, BBC health editor, Dr Mike Smith, trustee of the Patients Association, Daisy McAndrew, former economics editor at ITV, Chris Walters, chief economist at Monitor, which regulates health services in England, and Dr James Kingsland, president of the National Association of Primary Care. The discussion was chaired by Andrew Neil, chairman of The Spectator magazine group.
An early suggestion was to introduce charges. It was pointed out that in Sweden, one of Europe’s most left-wing countries, no one thought twice about paying the equivalent of £30 or £50 to see their GP. The NHS, it was argued, should be better at harnessing funds from the relatively well-off. Charges would also have the benefit of damping down demand.
Not everyone agreed. Such charges would raise little, it was argued, given all the exemptions that would be required.