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Dr Kailash Chand: 'Charging patients is not the answer'

In the long term, patient charges will cost more than they save argues BMA deputy chair Dr Kailash Chand

The NHS is facing a tough economic climate – but charging patients for important medical equipment that improves their health is not the answer.

I understand that CCGs are in a tight spot largely through the Government’s failure to provide the resources necessary for the NHS to cope with rising patient demand, especially from our ageing society. However, we should not move to a system where walking sticks, knee braces and wrist splints come with a price tag.  

If these are issued to patients it is because there is a clear clinical need for them from the patient’s perspective. It is not a nice little luxury they could do without, it is a key part of reducing pain and improving a patient’s life. By attaching a bill to these items all that will happen is that vulnerable people on low incomes, especially the growing numbers of people in their 70s and 80s, will not be able to afford them.

From a practical point of view this will clearly damage the health of a section of a population that is prone to other conditions and circumstances that will no doubt necessitate more admissions to hospital, visits to the GP and so on. In the long term, this measure will actually end up costing the NHS more money and waste further time, exacerbating the very problem that the introduction of charging is supposedly designed to solve.

Morally, there is also a strong, clear argument against charging people for treatment devices they need. This goes against the ethos of the NHS and could result in the beginning of a division between the ‘haves’ and ‘have nots’ in healthcare.

I am certainly not against CCGs, and others, striving for greater efficiency and making sure every penny is spent wisely. But we cannot and should not begin to undermine the care of our patients and return our nation’s cherished health system to the dark period before the Second World War, when the quality of your health depended on the size of your bank balance.

Dr Kailash Chand is deputy chair of the BMA and a retired GP.

Readers' comments (6)

  • Friend of mine recently bought a wheelchair off ebay for his decaying mother. When it arrived it had "XXXXXXX Hospital Trust" labels all over it. He returned it for a full refund and a suggestion that NHS such property is returned to its actual owners.

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  • Look around any Boot Sale and see the vast amount of NHS equipment that can be bought very cheaply!

    All NHS equipment should be branded, making it very clear it is NHS property not fro resale!

    folk that DLA / AA get this money to meet the extra costs of their care so why shouldn't they use that money to buy DLA's?

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  • Yet £3.00 take home per consultation and increasing and useless paperwork may drive GPs away. Ultimately, market forces will stop the NHS as it just cannot be afforded. I have done over 700 hundred 80 hour [ fri am to mon pm] weekends in the past and the NHS has always been based on untenable workloads,which is not sustainable.
    We cannot run at 100 mh everyday, which is what is happening, as there is no cash in the system and it will implode.
    Take Mid-Staffs, a 5* hospital in 1997, now closed due to staff cuts and only due to staff cuts to save money.
    Where is the money going to come from, Kailash, and how do other and better systems of healthcare operate around the world? The best ones charge a small fee.

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  • Vinci Ho

    Simple question:
    Whose fault is it that there is no money in the system ? Is it really the responsibility of people and CCGs to persist with this fallacy of 'efficiency saving' ?
    Are you really happier with the GDP rising faster , the so called average wage is now higher than inflation? Think clearly about the truth . The government will always spend money to save the banks and benefit private enterprises (look at the news about Starbucks) but not NHS because it is a socialist health system .
    So sad the Five Giant Evils ideology of William Beveridge is totally betrayed by a government of the GDP , for the GDP , by the GDP.

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  • American Journal of Medicine Volume 122 Issue 8 August 2009 Pages 741-746
    Illness and medical bills contribute to a large and increasing share of bankruptcies.

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  • It's not fair for taxpayers who already pay via their taxes to pay again at the doctor's door.If you're going to charge then make any contributions towards the NHS tax deductible.This implies having a transparent tax system where all the taxes are itemised so you know how much you pay for what.

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