Post by James Hammerton
A lot of people would dismiss all of these as symptoms of the lack of
funding for the NHS since Labour lost power (i.e. the impact of
coalition and then Tory policies), they might (correctly) cite the fact
that funding has dropped as a %age of GDP since then and if pressed on
the fact the the spending has outpaced the official measures of
inflation since 2010 (and thus has grown in real terms, at least as
officially defined) they might correctly point out that the rate of
growth in NHS spending was far higher under the last Labour government
(over 4% per annum IIRC) than it has been since then (around 1% per annum).
You are right. They are wrong.
I refer to the bar chart here:
However, raw numbers don't tell the whole story.
I go back to it's inception in 1948.
There ere great expectations of it including:
(a) The idea that costs would fall as prompt and efficient treatment reduced or even eradicated.
(b)That the anxiety perceived to be experienced by poor people and even those of modest means that one day they may be struck down by disease and not be in a position to 'buy the cure'
(c) That treatment should always be free at the point of delivery.
A lot of water has flowed under the bridge since 1948.
Infectious diseases like Polio, smallpox, diphtheria, TB, pneumonia etc. etc. have been largely eliminate at a cost of pennies thanks to modern antibiotics and immunisation techniques these were the killers of that day.
No so for the non pathogenic diseases such as cancer and heart diseases and the industrial diseases such as silicosis, emphysema, and chronic bronchitis. In 1948 patients whose life expectancy was about 67 years died of these whilst under palliative care. They still do. But these days palliative care aimed more towards sustaining and enhancing life is expensive. To be cynical if I may, it's an expensive way to die. A sufferer from Alzheimer's disease can be under constant residential care for 20 years. That's not the only down side of aging. an artificial hip can cost upwards of £10000 per limb and hopefully will only need to be changed once within a lifetime. Then there are transplants, hearts lungs, lungs, kidneys, corneas and God only knows what else.
It all adds up to a very expensive service indeed.
Something else has happened since 1948.
People have become wealthier. When I were a lad back in the 40's nobody in our street had a car, now everybody has one, TV sets were not yet available. Nobody went on foreign holidays. Bridlington, Scarborough or Blackpool was a far as you got if at all. Linoleum and 'clippie rugs' were the norm rather than fitted carpets or polished boarded floors and so on. No multi hundred pund Christmas' or multi thousand pound weddings.
There's plenty of money for the NHS. It's just a question of funding.
These sort of problems have hit these problems before. At the inception the service covered everything. Spectacles, dentistry, false teeth even wigs! In 1951 he country was suffering a financial crisis ( doesn't a labour government always have one?) and charges for these ancillary services as well as prescriptions were introduced. Aneurin Bevan the then MoH resigned in protest. Other than that, the sky did not fall in and these days we accept such charges as the norm.
IMV this is the only way forward for the NHS before it either collapses or breaks our backs. To begin with if any individual needs a treatment that is beyond his/her pocket then of course they have be helped. That goes without saying and is not the issue here.
There are a number of approaches to these problems. For instance, why does the NHS cover accidental injuries of any nature. An accident is a direct result of risk. Risk has been accommodated by insurance for 250 years or more. Why can't those who take the risks pay a few pounds insurance premium? My son a Swiss resident clumsily fell on and escalator sustaining quite a severe injury to his knee. I don't know what the cost was but what I do know is that the first £200 cost was his, and the rest was covered by insurance compulsorily arranged and paid for by his employer as a condition of employment.
When someone is suffers illness or mishap on the streets why should the taxpayer pick up his transport bill to hospital. If he couldn't carry such risk himself he could surely afford a few quid insurance to cover it.
We could go the whole hog and cap the amount the individual is liable to pay the NHS to (FSoA) £1000/year or maybe £120 in any one month. Again if anyone feels he can't afford the risk he can afford a modest insurance premium.
There are a great number of possibilities as to how the cost of the service, partially at least can be redirected to the user.
Why can't a patient pay a consultation fee to his GP? If he did, he would be unlikely to choose one who showed little interest or empathy with him. If he were given a voucher to pay or partially pay for his treatment he would be unlikely to go to a hospital or consultant with a bad reputation.
There is a number of bonuses too.
When you pay from your own pocket, you tend to take more notice of what you pay for.