Making patients pay for medical care would be one way of easing the cash crisis in the National Health Service, but it would deter those in need and undermine the principle of equal care for all, doctors' leaders say.
In a report published today, the British Medical Association considers options for charging patients in order to raise the extra pounds 1.5bn to pounds 2bn it says is necessary over the next four years to raise spending to the level of comparable countries.
It considers four levels of charges for a GP consultation from pounds 2.50 to pounds 10 which would raise between pounds 830m and pounds 3.3bn. If charges were restricted to home visits or night visits only, the sums raised would be lower. A pounds 10 night visit would bring in only pounds 14.5m.
Hotel charges for hospital stays, set at a flat rate to cover bed and board, might range from pounds 40 to pounds 80 and would raise up to pounds 2.5bn. However, if children under-16 and the over-65s were exempted, as currently for prescription charges, the sums raised would fall by half to a maximum of pounds 1.3bn.
The report also examines the option of raising prescription charges, currently pounds 5.65, to pounds 7.50 or pounds 10 which would raise up to an additional pounds 250m if existing exemptions from the charge (covering 83 per cent of all items dispensed) were continued.
Other options examined include increased private medical insurance, a social insurance system and income generation from private patient units and partnerships with business.
But the report concludes that public funding from taxation remains the best way of paying for the NHS.
Dr John Chisholm, chairman of the BMA's general medical services committee, said: "The NHS was a social experiment that led the world, but it is now failing because of chronic underfunding, and can no longer provide a comprehensive service meeting all needs."
He added: "If resources cannot be increased, the Government must set national standards for what the NHS will and will not provide."
The report claims that while patient charges could generate substantial additional funds, they would "dissuade the more vulnerable sections of the population from seeking medical help".
This, says the BMA, would lead to more serious health problems in the future.Reuse content