According to politicians, journalists and even exasperated frontline workers, the NHS is trembling on its last legs. Soul-searching, unsentimental reform and new thinking are, we are being told, required to resuscitate the health service and prevent its total collapse, just as nurses go on strike for livable working conditions and thousands die from emergency department delays alone. Being pumped out at a steady clip are an assortment of half-baked solutions for this crisis, one that was created in large part by the same austerian Tories who claim to have all of the answers.
Last month, Sajid Javid, the former secretary of state for health and social care, sang the praises of fees for GP and hospital visits. “Take Ireland,” he wrote of the country’s two-tier system, “where some people are entitled to free healthcare through the public system, based on household income.” He took stock of Germany, home to a typical European social insurance model, as well as the £20 GP fees in Norway and Sweden. In particularly effusive terms, he hailed the Irish Health Service Executive (HSE), giving the example of what he ludicrously calls a “nominal” €75 fee, payable by most in Ireland for a visit to an injury unit.
To combat NHS dysfunction, an NHS.2 should, in Javid’s judgement, involve a “contributory principle to complement public financing”. Such a system, he claims, gives one control over demand, redirecting it to “more efficient methods of supply”.
