George Osborne’s spending review for 2015/16 was the major political story of the week. NHS funding continues to be ring-fenced, but increasing demand within a capped budget means that so called ‘efficiency savings’ (cuts to you and me) will be a feature for the foreseeable future.
The chancellor’s statement overshadowed at debate at the BMA’s Annual Representative meeting in Edinburgh which called for an honest public debate about how the NHS continues ‘to deliver high-quality patient care in a climate of declining resources’. In proposing the motion, a doctor did suggest that top-up fees might be one possible option.
However, in a letter to The Times on the morning of Mr Osborne’s speech, Dr Mark Porter, chair of council, reemphasised that the BMA ‘remains opposed to charging for any services and believes that the NHS should remain free at the point of delivery’.
Leaving aside Dr Porter’s woeful ignorance of prescription and dental charges, it does raise the question as to whether the NHS would benefit from more charging or less. Charges were introduced in 1951 in the light of soaring bills for drugs and dentistry.
They came in to dampen down demand for these services and they continue to do this. 14% of non-paying adults have a Band 3 course of treatment as opposed to 5% of charge payers. Patients will buy pain killers or cough medicine rather than pay £7.65 an item on an NHS prescription.
Also on the same day as the chancellor was speaking, I was fitted with two NHS hearing aids, free at the point of delivery. I can also get free batteries at my local library. Specsavers is quoting this deal at £495 and others for anything up to £1500. Now had I needed a denture I would have paid an NHS charge of £209.
Where is the logic in that, unless you class my deafness as an industrial injury caused by the noise of drilling holes in teeth? Nevertheless, I could afford to have paid for the hearing aid or turned the TV up and asked people to repeat what they said more slowly or distinctly.
But free provision leads to potentially limitless demand. The NHS has a crisis in demand with us old blokes living longer, often with chronic conditions caused by past overindulgence. So will any government be brave enough to meet this demand problem by extending the range of NHS charges?
By news correspondent Michael Watson