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Independents' Day

NHS users should pay £10 a month, says former health minister

Patients in the UK should start paying a £10-a-month NHS ‘membership charge’ to save it from its funding crisis and help pay for annual MoT checks for everyone, a former Labour health minister has urged.

Lord Warner, who served under Tony Blair, warns that the NHS will become unsustainable without new sources of funding and painful changes, and recommends that everyone who is eligible for prescription charges should have to pay the £10-a-month charge.

This report followed a Pulse survey last year that showed more than half of GPs were in favour of charging for appointments.

The report, co-authored with Jack O’Sullivan, an expert in new thinking in health and social care, for the think-tank Reform said dramatic action was needed as the NHS faces an expected £30bn-a-year gap by 2020 between the demand for healthcare and its ability to respond.

It said: ‘A membership fee of £10 a month for all adults, with similar exemptions to those for prescription charges, would leave about 23 million people paying an annual fee. This would raise over £2bn a year for local programmes. We think that such a scheme might be popular, if the money went directly to local programmes rather than into central government coffers.’

It added: ‘NHS Membership could entitle more people than now to an annual “Health MOT”, running basic health checks. It would review progress over the previous year, agreeing individualised goals and NHS support for the coming year, with a focus on management of chronic conditions and more support for carers.’

Commenting on the proposals, Dr Ian Wilson, chairman of the BMA’s Representative Body, said: ‘Whilst some of [Lord Warner’s] proposals merit closer examination, resolving under-funding should not be at the expense of the most vulnerable in society nor at 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’.

Meanwhile, a recent opinion poll revealed that Britons are overwhelmingly against the introduction of GP charges to help the NHS balance its books.

According to the ComRes poll of 2,039 adults, commissioned by the Whitehouse Consultancy, a Westminster firm specialising in healthcare, one in four people said they would be willing to pay £10 for a GP visit rather than see their practice shutting down, but more than double that – 56% – were against.

The Pulse survey last year found that just over half of GPs are in favour of the NHS charging a small fee for routine appointments, with many believing it is the only way of managing their workload and curbing rising patient demand.

Of the 440 GPs polled in the survey, 51% said they would support charging a small fee for GP appointments, compared with 36% who would not.  

This was followed by a separate report from Reform that found that charging patients £10 a time to visit their GP would raise an extra £1.2bn a year in England.

Readers' comments (31)

  • Peter Swinyard

    interesting comment from Anonymous | 31 March 2014 12:21pm about getting in to hospitals the fees they should get from foreign nationals. The only way to do this is a credit card swipe from all entering hospitals - no charge to the entitled and a reasonable chance of recovery from those not entitled. The recovery rate of income managed by some hospital trusts is truly pitiful.

    On the 3.27pm comment, the Patients Association is an interesting beast - will not divulge how many members they have - one suspects not many. I debated "the end of GPs as we know it" with a representative of the patients association a week ago yesterday on Radio 5 Live (don't worry if you missed it...). They put up a retired GP who wanted to tell me that he and his partner used to have a list of 8000 patients and the two of them looked after them round the clock and he thinks modern GPs are slackers and moaners. I ventured to say that the day job is immensely more complex than it was in the "good old days".

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  • Took Early Retirement

    I think many of those who looked after lists of 4000 in the "good old days" are deluding themselves. the standard of care was often pretty abysmal from what one hears.
    A former partner at my place (now dead) used to consult at 2.5 minute intervals- yes, dear reader, 150 seconds and was heard to say "my patients are either well, or in hospital".

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  • Took Early Retirement

    Funny how the Noble Lord changes his tune once no longer in a Labour Govt!

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  • Bob Hodges

    I love the boys and their 'in my day anecdotes'.

    They could manage a list of thousands all by themselves, and still fit in more rounds of golf in an average working week than I manage trips to the toilet.

    Shame everyone died prematurely.

    The average person now has a better life expectancy than their GP.


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  • let's forget worrying about support of anybody, bad press etc..... it is time to be radical, for the sake of our profession, our health and, oddly enough, for the ultimate good of our patients! No pain, no gain, but without a significant upheaval, nothing will change, and general practice will continue to die - we're being pushed out, and I'm not looking to stay much longer, as I see no satisfaction dealing with consumers who think they know better than highly trained professionals and contribute so little to sustaining the NHS!

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  • Quit en masse, government will lose next election. Simple. Shame as a profession we have no cahoonies to do in oz! 30'something ex-gp partner

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  • well said, 10.30am.....only growing a real pair and taking such action will things change, but oh well, ain't gonna happen during my career, so Oz beckons, or private practice and other fun things!

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  • In many ways I love my job.
    i am able to establish a caring relationship with patients and their families over many years which allow them to trust me to put their care ahead any monetary need.
    I am saddened to see that most politicians (and the daily Wail) fail to grasp that GPs care about their patients.
    We need politicians with balls to stand up for the true needs of patients, continuity of care with good access and no political interference.

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  • He suggests £10 a month, as an incentive to get people to live healthier?? That is just another tax!!
    If patients had to pay £10 for each Dr contact, and start putting some value on the service they get, they might start to think - can I treat this myself, what could I have doen to prevent this? That is the onyl way forward a co-payment for a pay as you use service.

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  • the only way forward is to leave the NHS contract and have a system of direct payments (fairer) based on time/activity like almost all other services e.g. solicitors, barristers, dentists, accountants, etc.

    Indirect payments (insurance and government backed schemes preferably pre-paid vouchers) could also exist.

    Such a system is fairer and will still provide a safety net (government backed) for the poor but we would not be held hostage to unlimited demand for a fixed fee. It will solve supply/demand issues.

    Hard working GPs will be rewarded and could expand to cope with demand as they will have the resources coming in and best of all such a system will be free of NHSE interference and incompetence as income will be direct from the patient.

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  • We do pay every month, it is called a national Insurance contribution!

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