Patients should pay a fee to see their GP to reduce demand, a recent former health secretary has said.
Sajid Javid said the NHS could not ‘survive much longer’ without substantial change, including some fee payments to see GPs and emergency departments.
In an opinion piece published by The Times on Saturday (21 January), he called the current system ‘unsustainable’ and said the ‘barrier to reform’ is represented by the public’s appreciation of the NHS, which approaches that of ‘a religious fervour.’
He said that NHS’s only rationing mechanism, to make people wait, should be replaced by means-tested fees, while ‘protecting those on low incomes.’
He said: ‘We should look, on a cross-party basis, at extending the contributory principle. This conversation will not be easy, but it can help the NHS ration its finite supply more effectively.
‘Too often the appreciation for the NHS has become a religious fervour and a barrier to reform.
‘We need to shake off the constraints of political discourse and start having a grown-up, hard-headed conversation about alternatives.’
He added that Ireland’s ‘nominal’ €75 (£66) fee for attending an injury unit without a referral, and £20 fees charged for GP appointments in Norway and Sweden could represent possible models.
Writing in the Guardian in response to Mr Javid, former Labour Prime Minister Gordon Brown said that payment for services will end up causing people to miss early diagnoses and undermine the entire basis of the NHS.
He said: ‘The direction in which the Conservatives are travelling is already clear. The sick would pay for being sick and charging would force, as has happened with GP and hospital fees in France, the better-off sections of the population to take out private insurance – inevitably creating, in its wake, a two-tier healthcare system.
‘Today’s Conservatives may have clapped NHS nurses and health workers at the height of the pandemic; yet they are not only opposing decent remuneration for them, but also contemplating a more privately financed healthcare system.’
Prime Minister Rishi Sunak is not ‘currently’ considering the proposals, Downing Street told The Times.
During his campaign for the Tory leadership, Mr Sunak set out plans to issue £10 fines to patients who miss GP appointments.
But he backtracked on the pledge after it was widely criticised by GPs and health leaders.
Under the plans, it would have been up to GPs to make the judgement on whether to fine a patient.
Responding to claims that the Prime Minister was standing by the plans, a spokesperson told Pulse that they have actually been shelved following negative feedback from GPs.
Last year, when he was health secretary, Mr Javid floated ideas for GPs to link up with hospitals.