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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)

  • Hmm, and those most in need that are unable to afford this cost and need frequent GP attendances, what do they do?

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  • >what do they do?

    Sorting out the lower end isn't a problem - it's easy to arrange exemptions for those of a certain income, or reduced fees for chronic conditions. There are lots of possibilities.

    Let's not let small things distract us from the overview - £80 per year for unlimited GP care is not sustainable.

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  • Una Coales

    From the comments on BBC news websites and other sites today, the mere thought of paying £10/month is being met with a lot of hostility and entitlement to a totally free NHS. This means NHS GPs you are not going to get any public support or sympathy, and it is a case of each GP look out for yourself as the government continue to drop a pile of s%# on you to force you to leave any way shape or how and that includes making your appraisal as stressful as possible, revalidation as punitive and remediation impossible to keep self funding.

    They will put up huge hurdles and cut off funding to keep state NHS GPs from returning. They have not finished yet. Trainers will be forced to pay the wages of trainees so there will be no trainers of state NHS GPs.

    I am sorry but the only solution now has to be industrial action or a full strike as the last chance to save the NHS GP. The naive public have no idea that when the last NHS GP partnership is dissolved, privatisation will continue and it will not be £10/month for private medical insurance but more like £60/month for basic cover before top ups.

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  • In Sweden a public referendum was held to decide how best to support the Swedish healthcare system which whilst modelled on the NHS, was effectively being bankrupted by public demand (ring any bells?) The choice was: to pay an annual stipend per capita to support health care being free at point of contact or to opt for payment at point of contact for everything outside genuine emergency assessement and treatment. The public voted for the latter, and today have a health system which is efficient, effective and capable of manageing public demand because the public have been educated in the fiscal difference between clinical need and public demand!! Which I may suggest is exactly what needs to happen in the UK

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  • He also said there will be a £30 billion funding gap. If everyone in England paid £10 a month this would only raise £6 billion. Meanwhile Old Etonian Osbourne claims today that we are getting record tax reductions. NHS funding is paying for the tax cuts. If we want good quality NHS care we have to pay for it.

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  • I really dont think the British public is as reasonable as the Swedish.....this is all going to be very painful for GPS as Una quite rightly points out

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  • Lord Warner and the thinktank Reform are involved with the private health business, so they are not in any way "independent". Even so do their proposals have any merit? Not in my opinion. Bringing in additional income streams will undermine the basis of the NHS and cause harm to the poorest in our society. If more money is required for the NHS then it must come from taxation.

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  • Before we charge UK residents. How about ensuring people from abroad pay for any care given when they are not residents of the UK. Currently, hospitals and community services have a 'duty of care' to all who require medical care and once the care is complete the patient disappears back home and the bill for care remains unpaid. Sort this first then reassess.

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  • I find it deeply concerning that there is talk of charging anything for access to any service provided under the NHS which is supposed to be FREE at the point of contact. This would be the thin end of the wedge, leading to charging for A&E attendance, referrals to Consultants and other parts of the NHS, all talk of payment from patients for the services of the NHS should be stopped before the current Government get their way and fully install a 2 tier Health Service.

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  • I'll go to A&E for free thanks!
    For someone like myself (I rearely see a GP) I can get private care for the same amount - or will the price of this then skyrocket!
    Will this be an enforceable tax like the tv licence fee?
    Who gets the monety the DH who then sign it over to the treasury to patch over Osbornes deficit holes?

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