Charge £20 for GP appointments, says former health secretary

Telegraph

2 days ago

Patients should pay £20 for a GP appointment as part of an insurance-based NHS, a report backed by a former health secretary has said.
Sir Sajid Javid said Britain was 'long overdue' a 'serious conversation' about how the NHS was funded in the introduction to the report by Policy Exchange, the London think tank.
The paper advocates a Dutch-style social insurance model that would provide universal care to all who need it, but without the foibles of the US private healthcare system.
It claims switching to a largely insurance-funded NHS would halve the tax burden needed to pay for healthcare in the UK from 9 per cent of GDP to 4 per cent, saving about £128 billion per year.
This could reduce the average amount of tax paid by the public by around £2,400 a year, the paper argues.
Some of which would then be used to pay a health insurance premium for those who could afford to do so, with wider taxation covering the rest.
The authors of the report also argue that additional charges such as £20 for a GP appointment, scrapping free prescriptions for over-60s and introducing fines for missed appointments, would further raise funds – as well as incentivise a reduction in the wasteful use of the NHS and further limit the tax burden.
They also advocate charges for 'more luxurious hospital accommodation', which they say could raise £700 million.
Sir Sajid said the NHS spent its 'original yearly budget every month' and its funding was 'the size of the GDP of Portugal', accounting for 18 per cent of day-to-day government spending.
He wrote: 'We've come to a crossroads. A serious conversation with taxpayers about how we continue funding their favourite national institution is long overdue.
'We have two options. The first is to make an active choice to continue putting more and more money into healthcare, funded by yearly tax rises and by diverting essential investment into everything from education to defence towards the NHS.
'The second is reforming how we do healthcare. What we cannot afford to do is to bury our heads in the sand.'
The report says that 'under no circumstances should the UK consider moving towards the US model ', which is the only developed country with worse health outcomes than Britain, it says.
It notes that other countries 'with some sort of insurance-based model do much better', such as France, Germany and Singapore.
It spotlights the Netherlands model as one to which the UK could aspire. The Netherlands' 2006 health insurance Act merged a national health system with private insurance markets to create a universal social health insurance program.
It continues to provide universal coverage but has integrated a competitive, market-based insurance system.
Waiting times were shorter for the majority of treatments and procedures in the Netherlands while the country recovered from the Covid pandemic than they were in the UK before it hit.
The Dutch offered faster access in 2023 for various surgeries as well as hip and knee replacements than the NHS did in 2019. Since then, waiting times have soared in Britain.
The report says: 'We believe that better quality healthcare with universal coverage and improved long-term funding sustainability could be secured by moving from our present entirely socialised model to a hybrid model with a significant social insurance component.'
'An economic drag'
Policy Exchange advocates a system in which universal healthcare coverage is available and a basic model can be supplemented by other policies.
Outlining how the reform to the NHS would work in the UK, the report says the Government would regulate insurers and healthcare providers.
The think tank says the system should still be called the NHS – with the main change being 'about the way the system is financed'.
Roger Bootle, the head of Policy Exchange's policy programme for prosperity, and lead author of the report, said the 'NHS's economic drag is plain for all to see'.
He said: 'Waiting lists are longer, productivity is lower, and the burden on taxpayers has become intolerable.
'Worse still, UK health outcomes continue to stagnate, despite pouring billions more into the system, and are generally worse than other developed nations.
'We need a serious debate about not only the structure but also the funding of the NHS. Social insurance offers the only realistic way forward: a fairer, more sustainable system that delivers better outcomes for less money.'
A Department of Health and Social Care spokesman said: 'We remain absolutely committed to ensuring the NHS remains a publicly funded service, free at the point of use.
'We are taking bold action now to reform the health service to get it back on its feet and to make it fit for the future through our 10 Year Health Plan.
'We will seize the opportunities provided by new technology, medicines and innovation to deliver better care for all patients – no matter where they live or how much they earn – and better value for taxpayers.'