NHS 'to decline into safety net for old'

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The Independent Online

Public Policy Editor

Health ministers were yesterday involved in a damage limitation exercise in health as well as education after the retiring chairman of the NHS Trust Federation - which represents most NHS hospitals - declared that the health service had to become "a safety-net" for the old and the weak.

Tom Sackville, the junior health minister, was left protesting that was not government policy as Rodney Walker, the Trust Federation chairman, said people should be given tax-breaks to encourage them to take out private insurance.

"The NHS cannot carry on," Mr Walker told the federation's conference only a day after he had told Labour's health spokeswoman, Margaret Beckett, that those running NHS trusts did not feel they were part of "some insidious process towards privatisation".

Mr Walker's comments were disowned by Philip Hunt, director of the National Association of Health Authorities and Trusts, which represents both purchasers and providers in the NHS. While no one should underestimate the pressures on health care, Mr Hunt said, the NHS was "better placed than any other health care system" to meet them.

Mr Walker said an ageing population and medical advance would plunge the NHS into crisis, with lengthening queues for treatment, unless action was taken in the next five years to encourage private cover for non- emergency care.

Mr Sackville accused the man who has been a leading light in the NHS reforms of being "overly pessimistic".

There were pressures on health spending, he said, but Mr Walker "was perhaps overlooking the fact it's going to be necessary, before we start talking about rationing health care in some cases for elderly people, that we have to think about why we pay billions in benefit to young, able- bodied people. So it's going to be a question of shifting priorities ..."

Mrs Beckett claimed Mr Walker's comments had "blown the gaffe on this Government's long term plans for the NHS". What he was describing was two-tier care, she said. Alex Carlile, the Liberal Democrat spokesman, accused Mr Walker of "scaremongering".

Mr Walker's comments were all the more embarrassing coming just 48 hours after Stephen Dorrell, the Secretary of State for Health, had underlined that he saw the NHS "not as a safety net, but as a universal provider of high quality health and health care services".

Mr Walker cited forecasts that the NHS would need a 20 per cent real increase in funding early next century to maintain services.

Mr Hunt argued the NHS was cheap, efficient and effective and had over the past four years handled a 20 per cent rise in admissions at the same time as waiting lists had been cut drastically. "That is hardly the sign of a service in crisis."

A spokesman for the British Medical Association said it believed the NHS was underfunded, but if people could afford premiums for private health insurance they could afford higher taxes to pay for a properly-funded NHS.