Pay for healthcare? We already do. The 3 question MPs must answer.

A government minister has proposed setting up an inquiry to consider whether we need to move away from a tax-payer funded NHS to one that relies on insurance or co-payments. One reader's open letter to her MP.

Emma Bishton
20 July 2015

Below is an open letter to my MP, James Cartlidge, Conservative MP for South Suffolk.

Dear James Cartlidge

I understand that a few days ago the government health minister, Lord Prior, suggested during a Lords debate on the NHS that he would set up an inquiry into the future funding of the NHS. Apparently, now “demand outstrips supply” (as he put it) in the NHS, the inquiry needs to consider whether we need to move away from a tax-payer funded system to one based on insurance or other means of co-payment.

I am writing to you as it seems to me that as citizens – and therefore as taxpayers and NHS users – we should know whether Lord Prior was announcing government policy, or was going beyond his ministerial remit in proposing this debate. Yes the government needs to consider how to ensure the sustainability of the NHS in the short, medium and long-term. And yes as citizens we should engage to a degree in debates about priorities and the level of funding needed to meet them. But to have a minister announcing that an inquiry should be considering other forms of funding for the NHS – and explicitly, forms of funding which require those in need to pay – rather seems to give the game away.

I’m currently working in a community dementia service. Such services (despite the consumerist language used by Lord Prior and countless others) are not driven by demand, they are driven by need; very high levels of need for complex, scary conditions we all hope we never have to face, which pose huge demands on families, services and social care. Yet last Friday, as I drove home from work in that dementia service, I listened to a news article that outlined why proposed government changes to uplift the cap on people’s contributions to the cost of their care cannot now take place until 2020 because of the need to stabilise the social care crisis facing local authorities. This social care crisis isn’t a surprise: over the last few years the government has made local authorities the delivery agent for ‘austerity’, even though they are charged with looking after the most vulnerable people in society. Add to that the challenges of an increasing elderly population and the need for private care homes to make a profit, and a crisis is inevitable.

In 2011, David Cameron denied any suggestion that the NHS should move to a system where patients were asked to pay charges, or asked if they had insurance policies, saying:

“Let me make this clear - we will not be moving towards an insurance scheme, we will not introduce an American-style private system. In this country, we have this most wonderful, precious institution and idea. That whenever you're ill, however rich you are, you can walk into a hospital or surgery and get treated for free. No questions asked. No cash asked. I will never put that at risk.”

 If that is still his position why waste government time and resources on such an Inquiry?

Good healthcare costs money and we should not be shying away from that: a truly civilised society recognises need and seeks to meet it without punishing the people in need.

The people in the unit I’m working in aren’t choosing to be there. But their basic reason for accessing care is need. They, as older people, belong to the group much vaunted by the government as having worked hard all their lives. Don’t they deserve better than a fight about who should be paying for their basic care? Such a fight puts the person needing care in an even more vulnerable position than they are in already.

The NHS Constitution clearly states that the NHS belongs to us all. It doesn’t belong to an insurance company, or any other kind of co-payment organisations. If this Inquiry gets underway, and as debates about the sustainability of the NHS proceed, please will you undertake to do the following:
1) inform me if the Inquiry is part of government policy?

2) if it is not, ask questions and seek to ensure that such an Inquiry does not draw on government time and resources

3) in the course of public debates give your assurance that you will support the fundamental principle of the NHS as a service funded through taxation, and that you seek to use all influence available to you as a Conservative MP to promote a tax-payer funded NHS.

I look forward to hearing from you.

Yours sincerely

Emma Bishton

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