BMJ 2014;348:g2480 doi: 10.1136/bmj.g2480 (Published 31 March 2014)
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NEWS NHS should become a membership organisation, think tank says Clare Dyer BMJ
The NHS risks bankruptcy within five years unless the way it delivers services and is funded changes radically, says a report from the independent think tank Reform, which accuses the Labour Party and the coalition government of ignoring the developing crisis.1
Coauthored by Norman Warner, a Labour peer who was minister for health reform in Tony Blair’s government, the report articulates “the great unspoken truth of British politics . . . that the NHS, as it is run and as it is funded, risks seriously damaging other important public services.” Warner argues that the extra funds needed should come not from taxes on income but from a range of other sources, including higher “sin” taxes on alcohol, tobacco, gambling, and sugary foods; wider payment of inheritance tax; means testing of NHS “continuing care”; a monthly charge (say £10 (€12; $17)) for NHS membership, collected with council tax; and possible hotel charges for inpatient stays. But clinical care should continue to be free at the point of delivery, he says.
He calls for the NHS to become a National Health and Care Service. Most local hospital sites would be retained, but many would become hubs for integrated services that focus on early intervention in the community, while hospital specialist services
would be concentrated in fewer, higher quality centres with consultant cover 24 hours a day, seven days a week.
“The NHS has to change radically and fast over a single parliament, with flat-lined funding,” said Warner. “It should have no more handouts at the expense of other public services. It faces a hard slog of doing more with less and a tough conversation with the public about how we change services and accept new ways of funding.”
Ian Wilson, chairman of the BMA’s Representative Body, took issue with the idea of a monthly fee. “Lord Warner’s conclusion that the NHS is being driven into a worsening funding crisis will ring true with all who work in it,” he said. “Whilst some of his proposals merit closer examination, resolving underfunding should not be at the expense of the most vulnerable in society or the fundamental principle that the NHS needs to be free at the point of use, and the BMA firmly believes that charging for patients is not the solution.” 1
Warner N, O’Sullivan J. Solving the NHS care and cash crisis: routes to health and care renewal. Reform, 2014. http://reform.co.uk/resources/0000/1247/Solving_the_NHS_care_ and_cash_crisis.pdf.
Cite this as: BMJ 2014;348:g2480 © BMJ Publishing Group Ltd 2014
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS NHS should become a membership organisation, think tank says Clare Dyer BMJ
The NHS risks bankruptcy within five years unless the way it delivers services and is funded changes radically, says a report from the independent think tank Reform, which accuses the Labour Party and the coalition government of ignoring the developing crisis.1
Coauthored by Norman Warner, a Labour peer who was minister for health reform in Tony Blair’s government, the report articulates “the great unspoken truth of British politics . . . that the NHS, as it is run and as it is funded, risks seriously damaging other important public services.” Warner argues that the extra funds needed should come not from taxes on income but from a range of other sources, including higher “sin” taxes on alcohol, tobacco, gambling, and sugary foods; wider payment of inheritance tax; means testing of NHS “continuing care”; a monthly charge (say £10 (€12; $17)) for NHS membership, collected with council tax; and possible hotel charges for inpatient stays. But clinical care should continue to be free at the point of delivery, he says.
He calls for the NHS to become a National Health and Care Service. Most local hospital sites would be retained, but many would become hubs for integrated services that focus on early intervention in the community, while hospital specialist services
would be concentrated in fewer, higher quality centres with consultant cover 24 hours a day, seven days a week.
“The NHS has to change radically and fast over a single parliament, with flat-lined funding,” said Warner. “It should have no more handouts at the expense of other public services. It faces a hard slog of doing more with less and a tough conversation with the public about how we change services and accept new ways of funding.”
Ian Wilson, chairman of the BMA’s Representative Body, took issue with the idea of a monthly fee. “Lord Warner’s conclusion that the NHS is being driven into a worsening funding crisis will ring true with all who work in it,” he said. “Whilst some of his proposals merit closer examination, resolving underfunding should not be at the expense of the most vulnerable in society or the fundamental principle that the NHS needs to be free at the point of use, and the BMA firmly believes that charging for patients is not the solution.” 1
Warner N, O’Sullivan J. Solving the NHS care and cash crisis: routes to health and care renewal. Reform, 2014. http://reform.co.uk/resources/0000/1247/Solving_the_NHS_care_ and_cash_crisis.pdf.
Cite this as: BMJ 2014;348:g2480 © BMJ Publishing Group Ltd 2014
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
